Klin Onkol 1994; 7(6): 175-179.
Summary: 20-30% patients with refractory or relapsed testicular cancer cannot have benefit from chemotherapy in conventional doses. Long-term complete remission could be obtained using bone marrow autotransplantation (ABMT). ABMT involve the administration of very high doses of chemotherapy (with aim to treat tumor) followed by infusion of cryopreserved peripheral and/or marrow haemopoetic stem cells with the aim to overcome supraletal myeloid toxicity. The authors reported their experience with the use of this therapy in 29 years-old male with second relaps of testicular embryonal adenocarcinoma. The authors treated this patient with ultra-high dose of carboplatin (2000 mg/m2), etopside (1500mg/m2) and cyclophosphamide (120mg/kg)according to Linkesch et al. The therapy was complicated with hepatotoxicity (veno-occlusive disease of the liver) and gastrointestinal toxicity (enterocolitis and transient ileus). Recovery of granulocytes(above 0,5x10 9/l) was observed on day +11, the patient was discharged on day +15 without signes of regimen-related toxicity. He is alive and well ninth month after ABMT without evidence of disease. The authors also reviewed the studies done before and conclude that high-dose regimens followed by ABMT can realy overcome tumor resistence and that so it is possible to achieve long lasting compllete remission with reversible and acceptable nonhaematological toxicity. The results obtained are very promising especially in the light of the otherwise extremly poor prognosis of these patients. In the end the authors suggest multicentral cooperation to all oncological centres in Czech Republic in order to take part in International Study for the Salvage Treatment of Germ Cell Tumors coauting by European Group for Bone Marrow Transplantation.
