OverviewLung cancer is the leading cause of cancer-related death in the United States. An estimated 219,440 new cases (116,090 men; 103,350 women) of lung and bronchus cancer were diagnosed in 2009, and 159,390 deaths (88,900 men; 70,490 women) occurred from the disease.1 Only 15% of all lung cancer patients are alive 5 years or more after diagnosis

Most patients with non-small cell lung cancer (NSCLC) are diagnosed with advanced cancer. These guidelines only include information about stage IV NSCLC. Patients with widespread metastatic disease (stage IV) are candidates for systemic therapy, clinical trials, and/or palliative treatment. The goal is to identify patients with metastatic disease before initiating aggressive treatment, thus sparing these patients from unnecessary futile treatment. If metastatic disease is discovered during surgery, then extensive surgery is often aborted. Decisions about treatment should be based on multidisciplinary discussion.

Summary:ABMT may contribute to an improved clinical outcome. Further, patients receiving a PSCT may be more A majority of patients with intermediate or high-grade responsive to adjuvant immunotherapy following transnon-Hodgkin's lymphoma (NHL) who are treated with plantation. high-dose chemotherapy (HDT) and hematopoietic stem Keywords: PSCT; BMT; immunity; T cell; NHL; NK cell transplantation subsequently relapse. Until recently, cell F transplantation was associated with high morbidity and mortality and the focus was on improving the safety of this procedure. However, the use of growth factors and other supportive measures has successfully reduced High-dose chemotherapy (HDT) supported by hematopotreatment mortality to less than 5%. Therefore, new ietic stem cell transplantation and growth factor adminisstrategies need to be developed to eliminate the growth tration is increasingly used for patients with cancer. 1-3 Leuof any occult tumor cells reinfused with the stem cell kocyte and platelet recovery is more rapid following products and the tumor cells remaining in the patient.peripheral blood stem cell transplantation (PSCT) as comOne approach is to improve the immune function of the pared to bone marrow autografts (ABMT), if the peripheral patients by a more rapid immune reconstitution and stem cells (PSC) are collected after mobilization with hemaugmentation of effector cell function. We report studatopoietic growth factors, chemotherapy, or both. [4][5][6][7][8] In ies comparing immune recovery following HDT and addition, one retrospective study suggested an increase in autologous peripheral stem cell transplantation (PSCT) the progression-free interval following PSCT with steady as compared to autologous bone marrow transplanstate PSC as compared to ABMT, 9 although this obsertation (ABMT). These studies examined patients with vation requires confirmation as well as demonstration in a intermediate and high-grade non-Hodgkin's lymphoma prospectively randomized trial. 4,10,11 (NHL) who were treated with HDT and PSCT (n = 56) PSCT 6,12 may result in an earlier reconstitution of or ABMT (n = 60). The PSCT patients had a signifiimmune function following HDT as compared to cantly faster recovery of circulating monocytes (CD14 + ABMT 13,14 perhaps due to the lymphocytes that are trans- cells), natural killer ((NK) CD56 + ) cells, T helper (CD4 + )fused in the PSC product. To date, there have been limited cells, TCR␥/␦ cells, and naive T lymphocytes and conflicting studies on immune reconstitution following (CD45RA + ). Following ABMT there was a significantly PSCT and ABMT in humans. [15][16][17][18] Overall, there appears to more rapid increase in the frequency of T be wide phenotypic variability of cells in the suppressor/effector (CD8 + ) cells, B (CD19 + ) cells, CD34 + apheresis/transplant products themselves. 14 A significant cells, polymorphonuclear leukocytes (PMN) and memincrease in the frequency of CD8 + cells in the peripheral ory T lymphocytes (CD45RO + ). The CD4:CD8 and blood (PB) following both f...

Prolonged failure-free survival is possible following high-dose therapy and autologous hematopoietic rescue for follicular low-grade lymphoma. It is unclear whether patients are cured with this therapy or if survival is prolonged.

This prognostic model can identify patients with good and poor prognoses following high-dose chemotherapy and ABMT or PSCT for aggressive NHL. In good-prognosis patients, those who received PSCT had a superior FFS rate.