High-dose chemotherapy with bone marrow rescue for high-grade gliomas in adults

High-grade malignant gliomas are inevitably fatal, despite every effort to in improve this prognosis, including various radiotherapeutic modalities, radio- and chemotherapeutic associations and combinations of several drugs. High-dose chemotherapy and autologous bone-marrow transplantation (ABMT) have been increasingly used in the last 10 years for solid tumors, and several phase II studies in high-grade glioma patients have been conducted in the setting of both adjuvant treatment and recurrent disease. The most frequently used drug in the conditioning regimens is BCNU at doses higher than that employed by other regimens in other pathologies (800-1000 mg/ m(2)). These dosages involve a high toxicity that is not balanced by a significant improvement in survival. New drugs and/or regimens must be tested in randomized trials.