Journal of Cancer Research and Clinical Oncology

, Volume 131, Issue 4, pp 255–260

Secondary leukemia after first-line high-dose chemotherapy for patients with advanced germ cell cancer

Authors

  • J. Wierecky
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
  • C. Kollmannsberger
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
  • I. Boehlke
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
  • M. Kuczyk
    • Department of UrologyUniversity of Tuebingen Medical Center
  • J. Schleicher
    • Department of OncologyKatharinenhospital
  • N. Schleucher
    • Department of OncologyWestdeutsches Tumorzentrum Essen
  • B. Metzner
    • Department of Oncology and HematologyKlinikum Oldenburg
  • L. Kanz
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
  • J. T. Hartmann
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
    • Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical Center
Original Paper

DOI: 10.1007/s00432-004-0628-x

Cite this article as:
Wierecky, J., Kollmannsberger, C., Boehlke, I. et al. J Cancer Res Clin Oncol (2005) 131: 255. doi:10.1007/s00432-004-0628-x

Abstract

Purpose

We investigated the incidence of secondary leukemia in patients treated with first-line high-dose chemotherapy (HDCT) plus autologous stem cell transplantation (PBSCT) for advanced testicular cancer.

Methods

Three hundred and twenty-three patients who were entered into two consecutive prospective Phase-II studies of the German Testicular Cancer Study Group were analyzed. A total of 221 patients had received HD-VIP containing cisplatin, ifosfamide, and etoposide and 102 patients were treated with Tax-HD-VIP containing cisplatin, ifosfamide, etoposide, and paclitaxel, each cycle supported by autologous PBSCT.

Results

Patients had received a median cumulative etoposide dose of 4.9 g/m2 (range, 2.2–9.4 g/m2). The median follow-up duration for all patients was 36 months (range, 0–128) with a median follow up time of 50 months (range, 0–128) for patients surviving at least 1 year after therapy. One patient developed a secondary acute myeloid leukemia (s-AML) involving a chromosomal translocation t(11;19)(q23;p13.3) 24 months after the start of chemotherapy resulting in a cumulative incidence of 0.48% [95% confidence interval (CI) 0–1.42]. Additionally, two patients with primary mediastinal germ cell cancer developed a myelodysplastic syndrome. No solid tumors had occurred.

Conclusions

HDCT including high-dose etoposide with autologous PBSCT as first-line therapy for advanced testicular cancer was associated with an acceptably low risk of developing secondary leukemia.

Keywords

Secondary leukemiaHigh-dose chemotherapyEtoposideGerm cell cancer

Copyright information

© Springer-Verlag 2004