A Retrospective Study of Patients with Recurrent or Refractory Testicular Germ Cell Tumors Treated with High-dose Chemotherapy and Autologous Peripheral-blood Stem-cell Transplantation Single-center Experience

Ad dress for Cor res pon den ce: Şebnem İzmir Güner, Memorial Şişli Hospital, Hematology and Bone Marrow Transplantation Unite, İstanbul, Turkey Phone: +90 212 314 66 66 E-mail: sebnemizmirguner@gmail.com ORCID-ID: orcid.org/0000-0002-6326-9424 Re cei ved: 16.04.2019 Ac cep ted: 22.05.2019 Objective: Patients with recurrent metastatic germ cell tumor (GCT) can be treated with second-line or even third-line regimens; 20-30% of testicular GCT (TGCT) relapse or become refractory after first-line therapy and optimal treatment for this group is not very well defined. Materials and Methods: We presented the analysis of the efficacy of high-dose chemotherapy and peripheral-blood stem-cell transplantation in patients treated between 2016 and 2019. Five patients with five autologous stem-cell transplantations (ASCT) were analyzed retrospectively. All patients were treated with bleomycin, etoposide, cisplatin as first-line therapy and paclitaxel, ifosfamide, cisplatin was given as salvage chemotherapy. Stem–cell collection was performed with granulocyte stimulating factor. ASCT was performed with carboplatin (700 mg/m2) and etoposide (750 mg/ m2). The results were provided as median (min-max). Results: After ASCT, all patients were in complete remission (CR). The follow-up after ASCT was 12 months. At the 12-month follow-up, four patients were still alive and in CR, and only one patient died at 6th month after ASCT due to recurrence. Grade 2/4 toxicities were observed in five patients. Only one patient died due to complications of transplantation. Conclusion: Although the number of the patients in this study was limited, ASCT seemed to be a safe and effective treatment modality in recurrent refractory non-seminomatous TGCT, and treatment-related mortality was very low in this heavily pretreated group.