High dose chemotherapy with autologous bone marrow rescue in small cell lung cancer.
Wilson C., Pickering D., Stewart S., Vallis K., Kalofonos H., Cross A., Snook D., Goldman JM., McKenzie CG., Epenetos AA.
Twenty five patients diagnosed as having small cell lung cancer (SCLC) were treated with etoposide and cisplatinum. After assessment for tumour response, autologous bone marrow (ABM) was collected from five patients in good clinical state who had shown a partial response (PR) and no bone marrow involvement with tumour. These patients were treated with high dose cisplatinum, etoposide and melphalan and then by ABM infusion. Although all patients (3 with extensive and 2 with limited disease) responded (4 CR and 1 PR), 3 patients with extensive disease relapsed and died of their disease. One patient with limited disease died of infection while pancytopaenic; one patient is alive but has relapsed at eighteen months. Although patient numbers are small, our data support the conclusion that high dose chemotherapy and autologous bone marrow rescue has a very small role or none at all in the management of patients with extensive or limited stage SCLC.