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Annals of Oncology 3:809-812, 1992
© 1992 European Society for Medical Oncology

research-article

High-dose chemotheraphy supported with autologous bone marrow transplantation (ABMT) in germ cell tumors: A phase two study

G. Rosti1,, L. Albertazzi1, R. Salvioni2, G. Pizzocaro2, G. L. Cetto3, M. A. Bassetto3 and M. Marangolo1

1Medical Oncology Ravenna
2National Cancer Institute Milan
3Medical Oncology Verona, Italy

Dr. Giovanni Rosti Medical Oncology Ospedale Civile 48100 Ravenna, Italy

In this paper, the first Italian multicentre experience with high-dose chemotherapy and ABMT in germ cell cancer is presented. Twenty-eight patients underwent treatment with a carboplatin-etoposide w/o ifosfamide high-dose combination. Seventeen patients were in progression of disease, 9 were responsive to salvage treatments or failed to achieve CR to front line, and 2 had stable disease (both with an elevated marker level) at the time of transplantation. Five patients, all of whom were in sensitive relapse at transplantation, are alive and disease-free at > 17 months' follow-up. Two patients died 15 days after ABMT, one of veno-occlusive disease and one of rapid uncontrolled tumor progression. In highly pretreated patients this schedule seems to provide an option of cure for a cohort of patients failing to achieve CR to standard salvage regimens for germ cell cancer. Definitive conclusions may eventually be drawn with a more homogeneous group of patients. This type of approach should continue to be taken in sensitive relapse patients only, as responses in progressive cases are very transient, with virtually no cures. The question of whether high-dose programs are better than standard chemotherapy will in any case be answered only in a randomized prospective trial.

germ cell tumors, bone marrow transplantation, high-dose chemotherapy


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