title: Transient complete remission of metastasized Merkel cell carcinoma by high-dose polychemotherapy and autologous peripheral blood stem cell transplantation.
abstract: Merkel cell carcinoma (MCC) is a rare cutaneous tumour with neuroendocrine differentiation. Metastasis occurs preferentially to regional lymph nodes but distant and multiple visceral metastases may occur. Chemotherapy has been performed with a variety of protocols based largely on agents active in small-cell lung cancer. Owing to the rarity of MCC, there is no standard protocol for the treatment of metastatic disease. We report a 59-year-old patient with systemic metastatic MCC. After diagnosis of distant metastases, first-line polychemotherapy (cisplatin 80 mg m(-2), doxorubicin 50 mg m(-2), etoposide 300 mg m(-2) and bleomycin 30 mg) was administered four times at 3-weekly intervals and resulted in partial remission of metastases. Subsequently, high-dose chemotherapy according to the PEI regimen (ifosfamide 12 g m(-2), carboplatin 900 mg m(-2) and etoposide 1500 mg m(-2)) was applied, followed by autologous blood stem cell transplantation (ABSCT). This protocol resulted in a complete remission that lasted for 6 months. This is the first report on a complete remission of metastatic MCC after high-dose polychemotherapy and ABSCT. High-dose chemotherapy might be a therapeutic option in chemosensitive metastatic MCC, and further evaluation is warranted.
authors.affiliation: Department of Dermatology, University of Heidelberg, Vossstr. 2, 69115 Heidelberg, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Waldmann
authors.forename: H
authors.initials: H
authors.lastname: Goldschmidt
authors.forename: A
authors.initials: A
authors.lastname: Jäckel
authors.forename: M
authors.initials: M
authors.lastname: Deichmann
authors.forename: U
authors.initials: U
authors.lastname: Hegenbart
authors.forename: W
authors.initials: W
authors.lastname: Hartschuh
authors.forename: A
authors.initials: A
authors.lastname: Ho
authors.forename: H
authors.initials: H
authors.lastname: Näher
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D015266:Carcinoma, Merkel Cell / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012878:Skin Neoplasms
chemical_list: D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide