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Conditioning Regimens

First-line high-dose chemotherapy for patients with poor prognosis extragonadal germ cell tumors: the experience of the European Bone Marrow Transplantation (EBMT) Solid Tumors Working Party

Bone Marrow Transplantation volume 34, pages 1033–1037 (2004)Cite this article

Summary:

Extragonadal germ cell tumors are classified according to the staging system of the International Germ Cell Cancer Collaborative Group (IGCCCG). The 5-year overall and disease-free survival rates for poor prognosis patients are 41 and 48%, respectively after standard-dose chemotherapy. We report the experience of the EBMT Solid Tumours Working Party (STWP) with first-line HDCT with hematopoietic progenitor cell support (HPCS) in patients with poor prognosis extragonadal nonseminomatous germ cell tumor (NSGCT). Between 1990 and 2001, 22 extragonadal NSGCT patients (21 M, 1 F), median age 30 years (range 17–52) were treated with first-line HDCT with HPCS. Primary site was mediastinum in 11 patients, retroperitoneum in 10, and unknown in one. The Carbopec regimen, consisting of high doses of carboplatin, etoposide, and cyclophosphamide, was used in most cases (12 patients). No treatment-related deaths occurred. No patient developed myelodysplasia or a secondary leukemia. In total, 17 of 22 patients (77%) achieved complete remission. At a median follow-up of 50 months (range 26–132), 15 patients (68%) are alive disease-free. The survival rates of patients with poor prognosis extragonadal NSGCT treated with first-line HDCT in the EBMT STWP experience appear higher than that expected according to the IGCCCG classification.

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Authors and Affiliations

  1. Department of Oncology and Hematology, Istituto Oncologico Romagnolo, Santa Maria delle Croci Hospital, Ravenna, Italy

    G Rosti, U De Giorgi & G Papiani

  2. Department of Medical Oncology and Hematology, Klinikum Nuremberg, Germany

    H Wandt

  3. Department of Oncology and Hematology, University Hospital, Strasbourg, France

    B Lioure

  4. Centre Coordonné d'Oncologie, Lausanne, Switzerland

    S Leyvraz

  5. University Hospital, Mainz, Germany

    K Kolbe

  6. Unit of Biostatistics and Clinical Trials, Istituto Oncologico Romagnolo, Forlì, Italy

    M Ballardini

  7. Ankara University Medical School, Ankara, Turkey

    A Kulekci & T Demirer

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  1. G Rosti
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  2. U De Giorgi
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  7. G Papiani
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  8. M Ballardini
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  9. A Kulekci
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  10. T Demirer
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on behalf of the EBMT Solid Tumours Working Party

Corresponding author

Correspondence to G Rosti.

Appendix

Appendix

Institutions participating in this study

G Rosti, U De Giorgi, G Papiani, M Marangolo, Istituto Oncologico Romagnolo – Department of Oncology and Hematology, Santa Maria delle Croci Hospital, Ravenna, Italy; H Wandt, Department of Oncology and Hamatology, Klinikum Nuremberg, Germany; B Lioure, Department of Oncology and Hematology, University Hospital, Strasbourg, France; S Leyvraz, Centre Coordonné d’Oncologie, Lausanne, Switzerland; K Kolbe, Department of Medicine, Johannes Gutenberg University, Mainz, Germany; G Doelken, Ernst-Moritz-Arndt University, Greifswald, Germany; M Freund, Division of Hematology and Oncology, Department of Internal Medicine, University Hospital, Rostock, Germany; B Hertenstein, K Welte, R Blasczyk, Department of Hematology and Oncology, Hannover Medical School, Hannover, Germany; T Kozak, Department of Clinical Hematology, University Hospital Kralovske Vinohrady, Prague, Czech Republic; W Siegert, Charite, Campus Virchow Klinikum, Humboldt Universitat, Berlin, Germany; S Slavin, D Engelhard, Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah University Hospital, Jerusalem, Israel.

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Rosti, G., De Giorgi, U., Wandt, H. et al. First-line high-dose chemotherapy for patients with poor prognosis extragonadal germ cell tumors: the experience of the European Bone Marrow Transplantation (EBMT) Solid Tumors Working Party. Bone Marrow Transplant 34, 1033–1037 (2004). https://doi.org/10.1038/sj.bmt.1704704

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