title: High dose chemotherapy with stem cell support in the treatment of testicular cancer.
abstract: Testicular germ cell cancer (TGCC) is rare form of malignant disease that occurs mostly in young man between age 15 and 40. The worldwide incidence of TGCC is 1.5 per 100000 man with the highest rates in North Europe. After discovery of cisplatin cure rates of TGCC are very favorable between 90%-95% and unlike most solid tumors, cure rate for metastatic TGCC is around 80%. Metastatic TGCC is usually treated with 3-4 cycles of bleomycin, etoposide, cisplatinum chemotherapy with or without retroperitoneal surgery and cure rates with this approach are between 41% in poor risk group and 92% in good risk group of patients. Cure rates are lower in relapsed and refractory patients and many of them will die from the disease if not cured with first line chemotherapy. High dose chemotherapy (HDCT) approach was used for the first time during the 1980s. Progress in hematology allowed the possibility to keep autologous haematopoietic stem cells alive ex-vivo at very low temperatures and use them to repopulate the bone marrow after sub-lethal dose of intesive myeloablative chemotherapy. Despite the fact that there is no positive randomized study to prove HDCT concept, cure rates in relapsed TGCC are higher after high dose therapy then in historical controls in studies with conventional treatment. Here we review clinical studies in HDCT for TGCC, possibilities of mobilising sufficient number of stem cells and future directions in the treatment of this disease.
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Lazar
authors.initials: L
authors.lastname: Popovic
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Gorana
authors.initials: G
authors.lastname: Matovina-Brko
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Milica
authors.initials: M
authors.lastname: Popovic
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Petrovic
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Cvetanovic
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Vukojevic
authors.affiliation: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Jelena Vukojevic, Darjana Jovanovic, Medical School, University of Novi Sad, 21000 Novi Sad, Serbia.
authors.forename: Darjana
authors.initials: D
authors.lastname: Jovanovic
keywords: Germ-cell cancer; High dose chemotherapy; Plerixafor; Stem cell transplantation