Infections in patients treated with high-dose chemotherapy for germ cell tumours

Daugaard, Gedske; Nielsen, Henrik; Bruun, Brita; Hansen, F. R.; Geertsen, Poul F.; Schønheyder, Henrik Carl

doi:10.1016/0959-8049(93)90209-x

Cited by 5 publications

(1 citation statement)

References 4 publications

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“…Myelosuppression and infection are more frequent and severe with high-dose regimens. 98 Adverse effects more specific to each agent are listed in TABLE 4. Although some adverse effects are reversible, nephrotoxicity, ototoxicity, neuropathy, and infertility may persist in 20% to 40% of patients.…”

Section: Late Relapsesmentioning

confidence: 99%

Medical Treatment of Advanced Testicular Cancer

Feldman

Bosl²,

Sheinfeld³

et al. 2008

JAMA

332

225

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ESTICULAR CANCER IS THE MOST common cancer diagnosis in men between the ages of 15 and 35 years, with approximately 8000 cases detected in the United States annually. 1 The majority (95%) of testicular neoplasms are germ cell tumors (GCTs), with other testicular neoplasms (ie, sex-cord stromal tumors, lymphomas) occurring more rarely. Germ cell tumors may also arise in extragonadal locations, such as the mediastinum and retroperitoneum.Remarkable progress has been made in the medical treatment of advanced testicular cancer with a substantial increase in cure rates from approximately 25% in the mid-1970s to nearly 80% today. 2 This cure rate is the highest of any solid tumor and improved survival is primarily due to effective chemotherapy. 3 It is important for all physicians to be familiar with this malignancy, because patients may initially present to a variety of practitioners, and delays in therapy are associated with more extensive disease resulting in more intensive treatment and lower cure rates. 4 In addition, the immediate and longterm toxic effects of treatment often require management from physicians of various disciplines. This article reviews the current evidence-based treatments for advanced testicular GCT, and the acute and chronic toxic effects that may result. The management of early stage (I-IIA) testicular cancers has been reviewed elsewhere. [5][6][7] BACKGROUND GCT Histology and GeneticsGerm cell tumors are malignancies of primordial germ cells, the cells destined to become spermatozoa. With neoplastic transformation, these cells take on a variety of histologies, reflect-See also Patient Page. CME available online at www.jamaarchivescme.com and questions on p 706.

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Section: Late Relapsesmentioning

confidence: 99%

Medical Treatment of Advanced Testicular Cancer

Feldman

Bosl²,

Sheinfeld³

et al. 2008

JAMA

332

225

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Infectious Complications from High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Metastatic Germ Cell Tumors

Jathavedam

Feldman

Ishill

et al. 2008

Biology of Blood and Marrow Transplantation

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High-dose chemotherapy with autologous stem cell transplantation (ASCT) is increasingly utilized in patients with relapsed and refractory germ cell tumors (GCT). Infectious complications are common after ASCT for hematologic malignancies, but their epidemiology in GCT patients has not been described. To identify infectious complications of ASCT for GCT, we conducted a retrospective study of patients treated at our institution, a tertiary-care cancer center in New York City between 1994 and 2006. Patients received ciprofloxacin prophylaxis but no routine antifungal or antiviral prophylaxis. In addition, patients were housed in shared rooms of 2 with standard precautions during hospitalizations. Overall, 107 patients with relapsed or refractory GCT were treated with 1-2 cycles of paclitaxel/ifosfamide and 1-3 cycles of high-dose carboplatin/etoposide with ASCT. Sixty (56%) of 107 patients developed 95 total infections, including 33 catheter-associated bloodstream infections. Fungal, viral, and nosocomial infections were uncommon. There were no infection-related deaths. In conclusion, serious morbidity from infection is uncommon among GCT patients receiving high-dose chemotherapy with ASCT. Isolation and aggressive antifungal and antiviral prophylaxis is not warranted in these patients.

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First-line chemotherapy of non-seminomatous germ cell tumors(NSGCTs)

Pliarchopoulou

Pectasides

2009

Cancer Treatment Reviews

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Infections in patients treated with high-dose chemotherapy for germ cell tumours

Cited by 5 publications

References 4 publications

Medical Treatment of Advanced Testicular Cancer

Medical Treatment of Advanced Testicular Cancer

Infectious Complications from High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Metastatic Germ Cell Tumors

First-line chemotherapy of non-seminomatous germ cell tumors(NSGCTs)

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