Long-term disease-free survival in a child with refractory metastatic malignant germ cell tumor treated by high-dose chemotherapy with autologous bone marrow rescues.
We report the case of a 8-month-old girl who presented with a metastatic malignant germ cell tumor (MGCT) that proved to be resistant to chemotherapy, including salvage platinum-based combination therapy, surgery, and metastatectomy. The child was then treated with high-dose carboplatin, etoposide, and cyclophosphamide with autologous bone marrow rescue (ABMR) for two courses, since the first course was well tolerated and resulted in serum alpha-f etoprotein normalisation. The child remains in complete remission 3 years post-ABMR and 4 years post-diagnosis, with no detectable treatment-related sequelae. Thus, as already reported in adults, dose-intensive chemotherapy with ABMR may have curative potential in children with refractory MGCT.
Devalck
C
C
Oncology Unit, Hôpital Universitaire des Enfants, Université Libre de Bruxelles, Belgium.
Tempels
D
D
Ferster
A
A
De Laet
M H
MH
Bujan
W
W
Heiman
P
P
Sariban
E
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D001859:Bone Neoplasms / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D018237:Germinoma / Q000556:secondary* / Q000628:therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007223:Infant; D008113:Liver Neoplasms / Q000556:secondary; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D010386:Pelvic Neoplasms / Q000473:pathology / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D012445:Sacrococcygeal Region / Q000473:pathology; D016879:Salvage Therapy
D002945:Cisplatin; D007069:Ifosfamide