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Salvage chemotherapy with high-dose carboplatin plus etoposide and autologous peripheral blood stem cell transplant in male pure choriocarcinoma: a retrospective analysis of 13 cases

Bone Marrow Transplantation volume 40, pages 235–237 (2007)Cite this article

Abstract

Choriocarcinoma of testes is a very rare tumor with poor prognosis, usually presenting with high serum level of human chorionic gonadotropin (hCG>50 000 mIU/ml) and advanced hematogenous metastases. Data with salvage chemotherapy has been sparse, with few long-term survivors. Between April 1996 and October 2004, 184 patients with germ cell tumor were treated at Indiana University with salvage high-dose chemotherapy (HDCT) with autologous peripheral blood stem cell transplant. Thirteen had pure choriocarcinoma or choriocarcinoma syndrome (normal testes by palpation and ultrasound, normal serum alpha-fetoprotein, advanced hematogenous metastases and high level hCG). All patients had progressed following one or two lines of cisplatin combination therapy. HDCT regimen was carboplatin 700 mg/m2 and etoposide 750 mg/m2 intravenously given for 3 consecutive days. A second course was given after hematopoietic recovery, usually 3–4 weeks later. The median survival was 19 months (range 5–90). Six patients (46%) are alive and continuously disease free (cNED) at a median follow-up of 37 months (range 19–75). One additional patient who relapsed after HDCT and was treated with third line chemotherapy followed by two surgical resections of choriocarcinoma is currently alive NED at +90 months from HDCT. Long-term disease-free survival and potential cure is possible with HDCT in choriocarcinoma patients that progressed after standard cisplatin combination therapy.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Istituto Oncologico Romagnolo, Ravenna City Hospital, Ravenna, Italy

    G Papiani

  2. Division of Hematology-Oncology, School of Medicine and Walther Cancer Institute, Indiana University, Indianapolis, IN, USA

    L H Einhorn

  3. Lance Amstrong Foundation Professor of Medicine,

    L H Einhorn

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  1. G Papiani
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  2. L H Einhorn
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Correspondence to G Papiani.

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Papiani, G., Einhorn, L. Salvage chemotherapy with high-dose carboplatin plus etoposide and autologous peripheral blood stem cell transplant in male pure choriocarcinoma: a retrospective analysis of 13 cases. Bone Marrow Transplant 40, 235–237 (2007). https://doi.org/10.1038/sj.bmt.1705697

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