title: Long-term survivors after salvage high dose chemotherapy with bone marrow rescue in refractory germ cell cancer.
abstract: Between April 1984 and May 1985, 17 heavily pretreated patients with relapsing or refractory germ cell tumours were treated with cisplatin 40 mg/m2/day, days 1-5; etoposide 350 mg/m2/day, days 1-5; cyclophosphamide 1600 mg/m2/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.
authors.affiliation: Department of Medicine, Institut Gustave-Roussy, Villejuif, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Droz
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: M
authors.initials: M
authors.lastname: Ghosn
authors.forename: A
authors.initials: A
authors.lastname: Gouyette
authors.forename: D
authors.initials: D
authors.lastname: Baume
authors.forename: G
authors.initials: G
authors.lastname: Piot
authors.forename: M
authors.initials: M
authors.lastname: Ostronoff
authors.forename: C
authors.initials: C
authors.lastname: Theodore
authors.forename: F
authors.initials: F
authors.lastname: Beaujean
authors.forename: M
authors.initials: M
authors.lastname: Hayat
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis
chemical_list: D001761:Bleomycin; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin