High dose chemotherapy with stem cell support in thetreatment of testicular cancer

• 作者: Lazar Popovic, Gorana Matovina-Brko, Milica Popovic, Dragana Petrovic, Ana Cvetanovic, Jelena Vukojevic Darjana Jovanovic
• 来源期刊: 世界干细胞杂志：英文版（电子版）
• 学科: 医学
• 关键词: High DOSE CHEMOTHERAPY Germ-cell cancer Stem cell transplantation PLERIXAFOR
• 年，卷（期）: 2015,（11）
• 页码范围: 1222-1232
• 页数: 11页
• 分类号: R

摘要

Testicular germ cell cancer （TGCC） is rare form ofmalignant disease that occurs mostly in young manbetween age 15 and 40. The worldwide incidence ofTGCC is 1.5 per 100000 man with the highest rates inNorth Europe. After discovery of cisplatin cure ratesof TGCC are very favorable between 90%-95% andunlike most solid tumors, cure rate for metastatic TGCCis around 80%. Metastatic TGCC is usually treatedwith 3-4 cycles of bleomycin, etoposide, cisplatinumchemotherapy with or without retroperitoneal surgeryand cure rates with this approach are between 41% inpoor risk group and 92% in good risk group of patients.Cure rates are lower in relapsed and refractory patientsand many of them will die from the disease if not curedwith first line chemotherapy. High dose chemotherapy（HDCT） approach was used for the first time during the1980s. Progress in hematology allowed the possibility tokeep autologous haematopoietic stem cells alive ex-vivoat very low temperatures and use them to repopulatethe bone marrow after sub-lethal dose of intesivemyeloablative chemotherapy. Despite the fact thatthere is no positive randomized study to prove HDCTconcept, cure rates in relapsed TGCC are higher afterhigh dose therapy then in historical controls in studieswith conventional treatment. Here we review clinicalstudies in HDCT for TGCC, possibilities of mobilisingsufficient number of stem cells and future directions inthe treatment of this disease.