Clinical Impact of Germ Cell Tumor Cells in Apheresis Products of Patients Receiving High-Dose Chemotherapy

Bokemeyer, Carsten; Gillis, Ad J. M.; Pompe, K.; Mayer, Frank; Metzner, Bernd; Schleucher, N.; Schleicher, Jan; Pflugrad-Jauch, G.; Oosterhuis, J. Wolter; Kanz, Lothar; Looijenga, Leendert H. J.

doi:10.1200/jco.2001.19.12.3029

Cited by 17 publications

(11 citation statements)

References 20 publications

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“…Even in the submyeloablative HDCT, which might not absolutely require HSC rescue for engraftment, HSC infusion is known to speed recovery and decrease toxicities [5,21,22]. Clinical trials using PBSC between submyeloablative chemotherapy courses have successfully increased dose intensity by delivering chemotherapy at shorter intervals in patients with breast cancer, lung cancer, adult sarcomas, germ cell tumors, pediatric brain tumors, and pediatric soft tissue sarcomas [18,[23][24][25].…”

Section: Discussionmentioning

confidence: 97%

Feasibility of Sequential High-Dose Chemotherapy in Advanced Pediatric Solid Tumors

Kwon

Won

Han

et al. 2010

Pediatric Hematology and Oncology

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The purpose of this study was to evaluate the feasibility and tumor response of 3 cycles of sequential high-dose chemotherapy (HDCT) in advanced pediatric solid tumor patients. Medical records of 11 children who underwent 2 consequent courses of reduced conditioning HDCT followed by final HDCT with autologous HSC infusion were reviewed in a retrospective manner. Each median time to an absolute neutrophil count > 0.5 x 10(9)/L was 12, 13, and 12 days. Major toxic reactions were fever, infection, and vomiting. One patient experienced transplantation-related mortality. Nine patients showed complete and partial responses to the therapy at 6 months follow-up after final HDCT. Finally, 6 patients are alive without evidence of disease at median follow-up of 24 months. Even though it is a preliminary result, the authors think that this treatment could be a feasible treatment option for advanced pediatric solid tumor patients.

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Section: Discussionmentioning

confidence: 97%

Feasibility of Sequential High-Dose Chemotherapy in Advanced Pediatric Solid Tumors

Kwon

Won

Han

et al. 2010

Pediatric Hematology and Oncology

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“…Contamination of PBSCs with tumor cells has been recognized in a variety of solid tumors, including testicular cancer [13][14][15][16][17][18]. The biggest concern is potential engraftment of contaminating tumor cells after PBSCT and eventual treatment failure.…”

Section: Discussionmentioning

confidence: 99%

“…breast cancer [17,18], whereas this is not the case in testicular cancer [13] or neuroblastoma [15,16]. What about contaminating tumor markers in PBSCs?…”

Section: Discussionmentioning

confidence: 99%

False Tumor Marker Surge Evoked by Peripheral Blood Stem Cell Transplantation

et al. 2008

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Peripheral blood stem cell transplantation (PBSCT) allows multiple intensive chemotherapy treatments and hematopoietic progenitor cell rescues for poor-risk patients with a variety of malignancies. We report false surges of a tumor marker, serum human chorionic gonadotropin (hCG), evoked by PBSCT in the course of chemotherapy for a poor-risk testicular cancer patient. We confirmed that this phenomenon resulted from reinfusion of peripheral blood stem cells (PBSCs) containing hCG at a high concentration, collected when the patient's serum hCG levels were remarkably elevated. This is the first report to demonstrate false tumor marker surges caused by PBSCT. Because a rapid rise in tumor markers may demand an immediate change in the therapeutic strategy, physicians should be aware of the possibility of this phenomenon when treating poor-risk cancer patients whose tumor markers are remarkably elevated at the time of PBSC harvest. The Oncologist 2008;13:526 -529

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“…Interestingly, primary mediastinal NSGCT have been shown to express CXCR4, the receptor for the chemokine CXCL12, while the mediastinum expresses CXCL12 during embryonic development [12]. Altogether, these data suggest a peculiar interaction between primary mediastinalNSGCTandbonemarrowcells,whichmayhave clinicalimplicationsasillustratedbyourreport.However,it shouldbenotedthatpreviousstudieshaveidentifiedcirculatingtumorscellsinthebloodofpatientswithgermcelltumors whatever the primary site [13,14]. These studies failed to identifyanycorrelationwithclinicaloutcome.Inbreastcancer, the prognostic significance of circulating tumor cells is much less clear than for tumor cells in the bone marrow.…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Metastases in a Patient with Primary Mediastinal Non-Seminomatous Germ Cell Tumor – an Unusual Pattern of Relapse

Garbay¹,

Durrieu

Bui³

et al. 2012

Onkologie

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Background: Bone marrow is a very unusual site of metastasis for germ cell tumors. Case Report: We report the case of a 21-year-old male patient who was treated with chemotherapy and secondary surgery for a primary mediastinal non-seminomatous germ cell tumor (NSGCT). The patient achieved complete remission. However, 4 months after completion of therapy, he complained of rapidly worsening bone pain. No evidence for disease relapse was found in the computed tomography scan of thorax and abdomen, magnetic resonance imaging of the spine, or bone scan. A blood test revealed pancytopenia and elevated serum tumor markers. A bone marrow aspirate showed infiltration by tumor cells positive for AE1/AE3 and AFP confirming the diagnosis of isolated bone marrow metastatic relapse. Salvage chemotherapy was started and resulted in a rapid decrease of serum tumor markers. However, pancytopenia did not improve and the patient died of severe sepsis 3 weeks later. Conclusion: We report here the first case of isolated bone marrow metastatic relapse of an NSGCT. 2 other cases of bone marrow metastasis in patients with NSGCT have been reported. In these 2 cases, as in our patient, the primary site was not testicular but mediastinal suggesting a non-fortuitous association.

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Clinical Impact of Germ Cell Tumor Cells in Apheresis Products of Patients Receiving High-Dose Chemotherapy

Cited by 17 publications

References 20 publications

Feasibility of Sequential High-Dose Chemotherapy in Advanced Pediatric Solid Tumors

Feasibility of Sequential High-Dose Chemotherapy in Advanced Pediatric Solid Tumors

False Tumor Marker Surge Evoked by Peripheral Blood Stem Cell Transplantation

Bone Marrow Metastases in a Patient with Primary Mediastinal Non-Seminomatous Germ Cell Tumor – an Unusual Pattern of Relapse

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