High-dose chemotherapy with autologous stem cell transplantation in relapsed or refractory germ cell tumours: outcomes and prognostic variables in a case series of 17 patients

2014 ◽  
Vol 44 (8) ◽  
pp. 771-778 ◽  
Author(s):  
J. Lewin ◽  
M. Dickinson ◽  
M. Voskoboynik ◽  
M. Collins ◽  
D. Ritchie ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Germ Cell ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Case Series ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Germ Cell Tumours ◽  
Prognostic Variables

scholarly journals Melphalan, Etoposide, and Carboplatin Megatherapy with Autologous Stem Cell Transplantation in Children with Relapsing or Therapy-Resistant Extracranial Germ-Cell Tumors—A Retrospective Analysis

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3841
Author(s):  
Marek Ussowicz ◽  
Monika Mielcarek-Siedziuk ◽  
Jakub Musiał ◽  
Mateusz Stachowiak ◽  
Jadwiga Węcławek-Tompol ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Germ Cell ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
Observation Time ◽  
High Dose ◽  
Line Chemotherapy

Pediatric germ cell tumors (GCTs) are a group of chemosensitive malignancies with a 90% curability rate. We report a series of children with relapsing or therapy-resistant GCT treated with melphalan–etoposide–carboplatin high-dose chemotherapy (HDCT) and autologous stem cell transplantation. This consisted of 18 children, either with GCTs after relapse (nine patients) or with an unsatisfactory response to first-line chemotherapy (nine patients), who underwent HDCT. The HDCT regimens MEC1 (carboplatin 1500 mg/m2, etoposide 1800 mg/m2, and melphalan 140 mg/m2) and MEC2 (carboplatin 800 mg/m2, etoposide 800 mg/m2, and melphalan 140 mg/m2) were each used in nine patients. The median observation time was 81 months, the 5-year overall survival (OS) was 76%, and the event-free survival (EFS) was 70.8%. Non-relapse mortality was 0%, and four patients died after HDCT due to progression of the malignancy. No difference in OS or EFS was noted between the MEC1 and MEC2 protocols. The 5-year OS and 5-year EFS were higher in children treated with autologous stem cell transplantation before the age of four years. The presence of metastatic disease or time of HDCT consolidation during first/subsequent line chemotherapy did not affect patient survival. The melphalan–etoposide–carboplatin protocol is feasible in pediatric GCT, but is associated with potentially life-threatening complications. In conclusion, the use of HDCT must be examined in well-designed clinical trials, and the identification of patients who can benefit from this approach is critical to avoid overtreatment.

High-dose chemotherapy and autologous stem cell transplantation in refractory/metastatic nonseminomatous germ cell-tumors: A retrospective study of the Turkish Oncology Association.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15623-e15623
Author(s):  
Mustafa Ozturk ◽  
Fikret Arpaci ◽  
Sukru Ozaydin ◽  
Nuri Karadurmus ◽  
Evren Ozdemir ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Testicular Cancer ◽  
Germ Cell ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Combination Chemotherapy ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose

e15623 Background: Testicular cancer is a chemosensitive tumor that may be curable even in relapsed disease. Those patients who do not respond to standard combination chemotherapy or relaps may be treated with high-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) as salvage therapy. Methods: Eighty five patients that received HDC and ASCT between Feb 1993 - Dec 2012 in different university clinics of Turkey were retrospectively reviewed and evaluated. Results: Median age of the patients was 24 (range: 11-54 years) and 63 patients (74,1%) had stage III, 21 (24,7%) had stage II disease at initial diagnosis. The primary tumor location was testis in 71 patients (83,5%), and 14 patients (16,5%) had extragonadal region origin. Evaluation of metastatic focuses before HDC and ASCT was as follows: Liver metastasis (n = 23, 27.05%), lung involvement (n = 23, 27.05%) and multiorgan involvement (n =14, 16.47%) and other metastatic involvements (n=4, 4.7%). ICE (ifosfamide, carboplatin, etoposide) regimen was performed as HDC in all patients. Median follow-up was 59 (range: 8-218) months. Pre-ASCT patients’ condition was complete remission (n=28, 32.9%), partial remission (n=36, 42.4%) and never in CR (n=21, 24.7%) respectively. 32 patients (37.6%) relapsed or progressed within 1 year after HDC and ASCT median relaps was time 3 months (range: 0.3 - 36.13). Transplant related mortality was %3.5 and 3 patients died within the engraftment period after HDC. Five-year overall survival rate was 59.7%. Conclusions: HDC and ASCT is an effective and safe approach for patients with metastatic and refractory germ cell testicular cancer patients that do not respond to standard combination chemotherapy.

scholarly journals Successful Treatment with High-Dose Chemotherapy Followed by Autologous Stem-Cell Transplantation in a Patient with Metastatic Germ Cell Tumor

2021 ◽  
pp. 998-1003
Author(s):  
Jung Min Lee ◽  
Byung Woog Kang ◽  
Man-Hoon Han ◽  
Dong Won Baek
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Germ Cell ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Successful Treatment ◽  
Disease Free Survival ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Poor Risk

Although testicular germ cell tumors (GCTs) are known to curable disease even in cases with metastatic disease, patients in intermediate or poor-risk group may experience disease progression or refractory to the initial chemotherapy and needed second-line therapy. Long-term disease-free survival was unsatisfactory in relapsed/refractory patients with poor-risk factors and clinical trials for those patients are still insufficient. High-dose chemotherapy (HDCT) with stem-cell rescue may be an effective alternative for conventional chemotherapy-resistant patients who are eligible for transplantation. Herein, we present successful treatment experience with HDCT followed by autologous stem-cell transplantation in a severely ill patient with heavily pretreated metastatic GCT.

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