High-dose chemotherapy with autologous marrow transplantation for malignant melanoma. Case reports and literature review.

Present-day therapy for disseminated malignant melanoma is unsatisfactory; chemotherapy offers a small fraction of patients a short-lived palliative effect. Evidence exists to suggest more responses to chemotherapy could occur if dosages of chemotherapeutic agents were increased. The dosages of many chemotherapeutic agents used for melanoma are limited by myelotoxicity of the drugs. Autologous bone marrow transplantation offers a means to escalate chemotherapeutic dosages by shortening the period of life-threatening marrow toxicity to a survivable length of time. A review of 103 cases of melanoma treated with high-dose chemotherapy and autologous marrow rescue plus two cases reported here revealed that 48% of patients responded to therapy and 34% of those were complete responses. The exact role this technic will play in management of disseminated malignant melanoma requires further study.