Fig. 5.

Revisiting the administration of high dose chemotherapy. a Recent observations suggest that there is an increase in the level of EPC after pulse high dose chemotherapy. This increase may favor tumor progression and the establishment of distant metastases if these cells are recruited by the primary tumor and by pre-metastatic niches. b The administration of agents blocking the recruitment of VEGFR-1 and 2 positive BMDC between courses of high dose chemotherapy may prevent a stimulation of neo-angiogenesis and the formation of pre-metastatic niche post chemotherapy