High-dose chemotherapy with peripheral blood progenitor autografting.

Mobilized PBPs are an acceptable alternative to ABMT for hematopoietic rescue following high-dose therapy (table 10-3). Platelet recovery appears to be faster following PBPs than ABMT. In most series, leukocyte recovery is also accelerated, but this may be particularly due to the use of colony-stimulating factor. Morbidity and mortality also appear to be reduced. The optimal mobilization methodology is not defined, but larger numbers of PBPs are mobilized by chemotherapy plus colony-stimulating factors compared to CSFs alone, at the cost of enhanced toxicity. The use of PBPs has also facilitated the study of very-high-intensity regimens in which multiple courses of high-dose chemotherapy are given at very short intervals. Following completion of feasibility studies, prospective random assignment trials will be necessary to determine the benefit, if any, of this approach.