High-dose chemotherapy with autologous stem cell support is increasingly used in malignant disease. There are few data from randomized, controlled, clinical studies on which to base our approach, and many publications consist of retrospective analyses that do not help elucidate the overall role of high-dose therapy. There has been a rapid increase in the use of peripheral blood as a source of stem cells that may reduce the toxicity of the procedure, but this has spawned an enthusiasm for high-dose therapy particularly in conditions such as myeloma and solid tumors where, as yet, there are few clinical data to demonstrate survival benefit.