Long-term survivors after salvage high dose chemotherapy with bone marrow rescue in refractory germ cell cancer

• Published in: European journal of cancer & clinical oncology Vol. 27; no. 7; pp. 831 - 835
• Main Authors: Droz, J.P., Pico, J.L., Ghosn, M., Gouyette, A., Baume, D., Piot, G., Ostronoff, M., Theodore, C., Beaujean, F., Hayat, M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.1991
• Subjects: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bone Marrow Transplantation; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Dose-Response Relationship, Drug; Etoposide - administration & dosage; Etoposide - adverse effects; Humans; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - mortality; Prognosis
• ISSN: 0277-5379; 0959-8049
• DOI: 10.1016/0277-5379(91)90127-Y

Between April 1984 and May 1985, 17 heavily pretreated patients with relapsing or refractory germ cell tumours were treated with cisplatin 40 mg/m 2/day, days 1–5; etoposide 350 mg/m 2/day, days 1–5; cyclophosphamide 1600 mg/m 2/day, days 2–5 and autologous bone marrow transplantation on day 8 as consolidation of conventional salvage chemotherapy. None of the 11 refractory patients and 4 of the 6 responders to prior salvage treatment are long-term survivors at 68, 72, 74 and 74 months. Mean aplasia duration was 17 days and there were 7 documented episodes of septicaemia in 17 febrile patients. 1 patient died of treatment. Among the 4 survivors, 2 patients have a sustained grade II invalidating neuropathy. We conclude that this regimen is not recommended as salvage therapy in refractory patients but may be a useful consolidation treatment in patients responding to conventional salvage chemotherapy.