Special Section: Autologous Stem Cell Transplantations in Solid Tumours: Incidence and Prevention of Nonhaematological Toxicity of High-dose Chemotherapy

Abstract

The introduction of the haematopoietic growth factors (HGFs), together with the evolution of techniques to harvest haematopoietic stem cells from the peripheral blood, have greatly facilitated the use of high-dose chemotherapy (HDC). While haematological toxicity of HDC is no longer dose-limiting, damage to other tissues has become more pronounced. In fact, nonhaematological toxicity (NHTOX) is now often dose-limiting in HDC regimens. NHTOX associated with HDC regimens depends on the type and dose of the drugs used, the physical condition and the characteristics of the patients treated and the given comedication. We describe the most important toxic effects of commonly used HDC programmes, such as nausea, vomiting and mucositis, neutropaenic fever and sepsis, various major organ toxicities, catheter-associated problems and long-term complications. In addition, we discuss the possibilities of preventing these side-effects and what action to take if they occur.

Key Words:

• high-dose chemotherapy (HDC)
• nonhaematological toxicity (NHTOX)
• haematopoietic growth factors (HGFs)
• peripheral blood stem cell transfusion (PBSCT)
• chemoprotection