High dose chemotherapy with autologous bone marrow rescue for high grade gliomas of the brain: A potential for improvement in therapeutic results

Improvements in the therapy of high grade gliomas have not been achieved since the addition of single agent chemotherapy to operation and radiation therapy in the mid-1970s. The dosages of nitrosourea compounds commonly used as chemotherapeutic agents for malignant gliomas have been limited by the myelotoxicity of the drugs. Autologous bone marrow transplantation offers a means to escalate chemotherapeutic dosages by reversing marrow toxicity. Early studies indicated that complete responses, partial responses, and clinical responses are possible using high dose chemotherapy and autologous marrow rescue. The exact role that this technique will play in the management of malignant gliomas has not yet been determined.