High‐dose combination chemotherapy with autologous bone marrow transplantation in adult solid tumors

In order to determine whether high‐dose combination chemotherapy was active in chemotherapy resistant patients, 19 patients, (9 with small cell bronchogenic carcinoma, 6 with embryonal cell carcinoma, 2 with diffuse histiocytic lymphoma, 1 with Hodgkin's disease and 1 with chondrosarcoma), 18 of whom had had extensive prior chemotherapy and failed, received 23 courses of high‐dose chemotherapy with autologous bone marrow infusion (ABMT). Three patients received four courses of cytoxan (2–6 g/m2) and VP‐16 (500–600 mg/m2) and 16 patients received 19 courses of cytoxan and VP‐16 in these doses plus BCNU (300 mg/m2). Activity was observed in 6 of 8 evaluable small cell bronchogenic carcinoma patients (1 complete response (CR), 4 partial responses (PR), 1 < PR), in 6 embryonal cell carcinoma patients (3 CR, 2 PR, 1 < PR), in both patients with diffuse histiocytic lymphoma (1 CR, 1 < PR), in the patient with Hodgkin's disease (1 PR); and in the patient with chondrosarcoma (stable). Only 2 patients who had received prior cytoxan and VP‐16 extensively showed resistance to these programs. The median response duration was 11 weeks (range = 4–55+ weeks). Major toxicity consisted of bacterial infections. Two patients died from treatment related causes. Neutrophils recovered to levels of ⩾ 1.5 × 109/liter by days 20–42 (median, day 27) and platelets to levels of ⩾ 100 × 109/liter by days 21–56 (median, day 32) without any delayed BCNU toxicity. High‐dose combination chemotherapy with ABMT causes acceptable toxicity and high response rates of relatively short duration in tumors refractory to conventional chemotherapy.