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

  • J. Wierecky
  • C. Kollmannsberger
  • I. Boehlke
  • M. Kuczyk
  • J. Schleicher
  • N. Schleucher
  • B. Metzner
  • L. Kanz
  • J. T. Hartmann
  • C. Bokemeyer
Original Paper

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 leukemia High-dose chemotherapy Etoposide Germ cell cancer 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • J. Wierecky
    • 1
  • C. Kollmannsberger
    • 1
  • I. Boehlke
    • 1
  • M. Kuczyk
    • 2
  • J. Schleicher
    • 3
  • N. Schleucher
    • 4
  • B. Metzner
    • 5
  • L. Kanz
    • 1
  • J. T. Hartmann
    • 1
  • C. Bokemeyer
    • 1
  1. 1.Department of Oncology, Hematology, Immunology, and Rheumatology, Medizinische KlinikUniversity of Tuebingen Medical CenterTuebingenGermany
  2. 2.Department of UrologyUniversity of Tuebingen Medical CenterTuebingenGermany
  3. 3.Department of OncologyKatharinenhospitalStuttgartGermany
  4. 4.Department of OncologyWestdeutsches Tumorzentrum EssenEssenGermany
  5. 5.Department of Oncology and HematologyKlinikum OldenburgOldenburgGermany

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