title: Detection of germ-cell tumor cells in peripheral blood progenitor cell harvests: impact on clinical outcome.
abstract: Our study was conducted to evaluate the impact of tumor cell contamination in peripheral blood progenitor cell (PBPC) harvests on the clinical outcome of patients with germ-cell tumors undergoing high-dose chemotherapy (HDCT) and autologous PBPC reinfusion. Samples of mononuclear cells from progenitor cell harvests of 57 patients with advanced or recurrent germ-cell tumors were retrospectively screened for contaminating tumor cells using immunocytochemical staining for cytokeratin filaments and reverse transcription-PCR (RT-PCR) testing for germ-cell alkaline phosphatase mRNA. The results were correlated to clinical prognostic variables as well as to the overall and event-free survival of these patients. Tumor cell contamination was detected in PBPC harvests of 16 of 57 enrolled patients (28%), and, among these, in 14 of 51 (27%) who underwent HDCT. The presence of contaminating tumor cells as detected by either immunocytochemical staining, RT-PCR, or both was strongly associated with a reduced overall survival (43% versus 71%, P = 0.0037) and event-free survival (0% versus 52%, P = 0.0005) after 1 year. In multivariate analysis, the demonstration of contaminating tumor cells had a higher predictive value for a poor event-free survival than other known prognostic variables. The presence of contaminating tumor cells in PBPC harvests of patients with germ-cell tumors seems to predict a poor overall and event-free survival in patients undergoing HDCT and autologous PBPC reinfusion.
authors.affiliation: Department of Internal Medicine, Humboldt-Universität zu Berlin, Germany. hildebra@charite.de
authors.forename: M
authors.initials: M
authors.lastname: Hildebrandt
authors.forename: O
authors.initials: O
authors.lastname: Rick
authors.forename: A
authors.initials: A
authors.lastname: Salama
authors.forename: W
authors.initials: W
authors.lastname: Siegert
authors.forename: D
authors.initials: D
authors.lastname: Huhn
authors.forename: J
authors.initials: J
authors.lastname: Beyer
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002945:Cisplatin / Q000494:pharmacology; D018076:DNA, Complementary / Q000378:metabolism; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood* / Q000188:drug therapy* / Q000378:metabolism*; D011379:Prognosis; D012313:RNA / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016879:Salvage Therapy; D013234:Stem Cells / Q000166:cytology* / Q000378:metabolism*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D018076:DNA, Complementary; D012333:RNA, Messenger; D012313:RNA; D000469:Alkaline Phosphatase; D002945:Cisplatin