scholarly journals GCT-28. RECURRENCE PATTERN AND SURVIVAL FOR RELAPSED INTRACRANIAL NON-GERMINOMATOUS GERM CELL TUMORS: A SINGLE-INSTITUTION EXPERIENCE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii333-iii333
Author(s):  
Lei Wen ◽  
Zhaoming Zhou ◽  
Qingjun Hu ◽  
Juan Li ◽  
Mingyao Lai ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Late Recurrence ◽  
Salvage Chemotherapy ◽  
Recurrence Time ◽  
First Line ◽  
Primary Tumor Site ◽  
First Line Therapy ◽  
Line Therapy

Abstract PURPOSE Intracranial non-germinomatous germ cell tumors (NGGCTs) have lower overall survival than germinoma because relatively higher recurrence usually occurs after first line therapy. METHODS Between January 2003 and December 2018, 111 consecutive patients diagnosed with NGGCTs reviewed. Those who progressed after first line therapy were included in this study. Data of first line treatment, salvage treatment, clinicopathological features and survival were collected and analyzed. RESULTS Totally, thirty patients (30/111, 27.0%) relapsed in our cohort, including 19 patients with accurate relapse information detail, and 11 patients who died of disease progression during follow up but without exact time and site of relapse. The median OS from diagnosis of the disease was 49.2 months (95% CI: 14.1 to 84.3 months) and 3-year OS was 54.3%. Patients who received both CSI and chemotherapy relapsed less than those who received reduced volume of radiotherapy or only CSI or only chemotherapy (22.5% vs. 45.5%, p=0.034). Of 19 patients who had detail information of recurrence time and site, the median time from diagnosis of disease to relapse was 9.5 months (2.2 to 72.1 months). Regarding to recurrence site, most patients relapsed in primary site (10/19, 52.6%) or distant intracranial (6/19, 31.6%). The recurrence site of other 3 patients were spinal (n=1), ventricular (n=1) and peritoneal (n=1). CONCLUSION Protracted follow-up is recommended because late recurrence is not uncommon. Primary tumor site and distant intracranial are the most prevalent relapsed location. Patients who relapsed could benefited from both CSI and salvage chemotherapy.

scholarly journals GERM-01. RECURRENCE PATTERN AND SURVIVAL FOR RELAPSED INTRACRANIAL NON-GERMINOMATOUS GERM CELL TUMORS: A SINGLE-INSTITUTION EXPERIENCE

2021 ◽  
Vol 23 (Supplement_1) ◽  
pp. i16-i16
Author(s):  
Lei Wen
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Late Recurrence ◽  
Salvage Chemotherapy ◽  
Recurrence Time ◽  
First Line ◽  
Primary Tumor Site ◽  
First Line Therapy ◽  
Line Therapy

Abstract Purpose Intracranial non-germinomatous germ cell tumors (NGGCTs) have lower overall survival than germinoma because relatively higher recurrence usually occurs after first line therapy. Methods Between January 2003 and December 2018, 111 consecutive patients diagnosed with NGGCTs reviewed. Those who progressed after first line therapy were included in this study. Data of first line treatment, salvage treatment, clinicopathological features and survival were collected and analyzed. Results Totally, thirty patients (30/111, 27.0%) relapsed in our cohort, including 19 patients with accurate relapse information detail, and 11 patients who died of disease progression during follow up but without exact time and site of relapse. The median OS from diagnosis of the disease was 49.2 months (95% CI: 14.1 to 84.3 months) and 3-year OS was 54.3%. Patients who received both CSI and chemotherapy relapsed less than those who received reduced volume of radiotherapy or only CSI or only chemotherapy (22.5% vs. 45.5%, p=0.034). Of 19 patients who had detail information of recurrence time and site, the median time from diagnosis of disease to relapse was 9.5 months (2.2 to 72.1 months). Regarding to recurrence site, most patients relapsed in primary site (10/19, 52.6%) or distant intracranial (6/19, 31.6%). The recurrence site of other 3 patients were spinal (n=1), ventricular (n=1) and peritoneal (n=1). Conclusion Protracted follow-up is recommended because late recurrence is not uncommon. Primary tumor site and distant intracranial are the most prevalent relapsed location. Patients who relapsed could benefited from both CSI and salvage chemotherapy.

scholarly journals RARE-56. RECURRENCE PATTERN AND SURVIVAL FOR RELAPSED INTRACRANIAL NON-GERMINOMATOUS GERM CELL TUMORS: A SINGLE-INSTITUTION EXPERIENCE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi233-vi233
Author(s):  
Lei Wen ◽  
Zhaoming Zhou ◽  
Juan Li ◽  
Cheng Zhou ◽  
Mingyao Lai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Salvage Chemotherapy ◽  
Primary Site ◽  
First Line ◽  
Primary Tumor Site ◽  
First Line Therapy ◽  
Line Therapy

Abstract PURPOSE Intracranial non-germinomatous germ cell tumors (NGGCTs) have lower overall survival than germinoma because higher recurrence usually occurs after first line therapy in NGGCTs. METHODS Between January 2003 and December 2017, 23 patients with clinically or pathologically diagnosed recurrent NGGCTs after first line therapy were reviewed at our institution. Data of first line treatment, salvage treatment, clinicopathological features and survival were collected and analyzed. RESULTS First line therapy including craniospinal irradiation (CSI) in 15 patients, surgery in 3 patients, Gamma knife in 2 patients, chemotherapy in 2 patients and whole brain radiotherapy (WBRT) in 1 patient. The median time to recurrence was 13.8 months (5.8 to 89.2). With reference to the distribution of relapsed lesions, there were 8 patients within the primary site, 6 with distant intracranially, 1 ventricularly, 5 in spinal cords, 1 with dual sites in both primary site and intracranially, and 1 patient evidenced only serologically positive. Three patients did not receive further treatment and was lost during follow-up. Of the other patients, 16 patients received salvage chemotherapy with or without surgery, 4 received CSI or radiosurgery. After median follow up of 54 months, 7 patients died of disease progression. The 4-year overall survival rate after recurrence was 55.4%. CONCLUSION Protracted follow-up is recommended because late recurrence is not uncommon. Primary tumor site and distant intracranial are the most prevalent relapsed location. Patients who relapsed could benefited from salvage chemotherapy.

Ifosfamide- and cisplatin-containing chemotherapy as first-line salvage therapy in germ cell tumors: response and survival.

1997 ◽  
Vol 15 (7) ◽  
pp. 2559-2563 ◽  
Author(s):  
J A McCaffrey ◽  
M Mazumdar ◽  
D F Bajorin ◽  
G J Bosl ◽  
V Vlamis ◽  
...  
Keyword(s):  
Germ Cell ◽  
Median Survival ◽  
Primary Tumor ◽  
Median Survival Time ◽  
Germ Cell Tumors ◽  
Tumor Site ◽  
First Line ◽  
Primary Tumor Site ◽  
First Line Therapy ◽  
Line Therapy

PURPOSE To evaluate the efficacy and toxicity of ifosfamide- and cisplatin-containing chemotherapy as first-line salvage treatment for patients with germ cell tumors (GCT). PATIENTS AND METHODS Fifty-six patients with advanced GCT resistant to one prior cisplatin-containing regimen were treated with a salvage chemotherapy regimen of ifosfamide, cisplatin, and either vinblastine or etoposide (VeIP/VIP). RESULTS Twenty of 56 (36%) assessable patients achieved a complete response (CR). Thirteen (23%) are alive and continuously free of disease at a median follow-up time of 52 months; the median survival duration was 18 months. Among patients with a testis primary tumor site and a prior CR to first-line therapy, 65% are alive and 41% continuously disease-free, and the median survival time has not been reached. In contrast, for patients with an extragonadal primary tumor or with a testis primary tumor site and an incomplete response (IR) to first-line therapy, 31% are alive and 15% continuously free of disease, with a median survival time of 12 months (P < .03). CONCLUSION Ifosfamide- and cisplatin-containing therapy achieves a durable CR in a minority of patients with resistant GCT as first-line therapy. Patients with a primary testis site who relapsed from a CR to first-line cisplatin therapy have a better prognosis than patients with an extragonadal primary tumor site or an IR to first-line therapy. Risk-directed clinical trials to improve response and survival in both subsets are warranted.

scholarly journals TREATMENT RESULTS OF VIP (ETOPOSIDE, IFOSFAMIDE AND CISPLATIN) CHEMOTHERAPY AS A FIRST-LINE THERAPY IN METASTATIC GERM CELL TUMORS

2000 ◽  
Vol 91 (2) ◽  
pp. 55-61
Author(s):  
Tetsuya Yoshida ◽  
Junji Yonese ◽  
Tetsurou Tsukamoto ◽  
Sin-ichi Kitsukawa ◽  
Taisei Kin ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
First Line ◽  
Treatment Results ◽  
First Line Therapy ◽  
Line Therapy

scholarly journals Treatment and outcomes of UK and German patients with relapsed intracranial germ cell tumors following uniform first-line therapy

2017 ◽  
Vol 141 (3) ◽  
pp. 621-635 ◽  
Author(s):  
Matthew J. Murray ◽  
Shivani Bailey ◽  
Katja Heinemann ◽  
Jillian Mann ◽  
Ulrich K Göbel ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Intracranial Germ Cell Tumors

Autologous Stem Cell Transplantation Followed By Allogeneic SCT Provides Promising Results in Patients with Relapsed DLBCL and Adverse Prognostic Features Compared with ASCT Alone

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2034-2034
Author(s):  
Roberto Crocchiolo ◽  
Barbara Sarina ◽  
Stefania Bramanti ◽  
Lucio Morabito ◽  
Andrea Rimondo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Survival Rate ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Salvage Chemotherapy ◽  
First Line ◽  
Prognostic Features ◽  
First Line Therapy ◽  
Line Therapy

Abstract INTRODUCTION: high-dose chemotherapy (HDC) followed by autologous hematopoietic stem cell transplantation (ASCT) is a curative option for relapsed diffuse large B-cell lymphoma (DLBCL). However, relapse within 1 year after diagnosis, previous therapy with rituximab and secondary IPI = 2 or 3 have been associated with unsatisfactory outcome even after ASCT, thus the better treatment of these patients is matter of debate and efforts are ongoing in order to improve survival. METHODS: on a total of 146 DLBCL patients receiving ASCT, we identified 78 adult patients who had responsive but still measurable disease after first-line therapy or relapsed/progressive disease with one or more adverse features as specified above. All patients were >18 years old and received ASCT at our institution. Patients were grouped according to the administered treatment: 1) n= 21 patients were in response but not in complete remission (CR) after first-line and received HDC and ASCT; 2) n= 48 patients had refractory or relapsed disease and received salvage chemotherapy followed by HDC and ASCT (n=46 single ASCT, n=2 double ASCT); 3) n=9 patients received salvage therapy then tandem autologous-allogeneic SCT due to the presence of any of the above mentioned adverse features. For all patients, salvage chemotherapy was mostly VIHA or DHAP with the addition of rituximab. Most used regimens of HDC were Melphalan 200 mg/mq or BEAM. Among the nine patients undergoing tandem auto-allo, eight received Melphalan 200 mg/mq and one BEAM; allogeneic donors were either HLA-identical siblings (n=3), unrelated (n=1) or haploidentical ones (n=5). All conditioning regimens before allogeneic SCT were reduced-intensity or nonmyeloablative. RESULTS: at last follow-up, survival rate is 57% for group 1 (12 alive out of 21 patients), 27% for group 2 (13/48) and 67% for group 3 (6/9). Cause of death in this last group was disease relapse/progression for all 3 cases (2 patients were in partial remission (PR) before allo, 1 in CR). Disease status before allogeneic SCT for the 6 alive patients was CR (n=3) and PR (n=3). Their follow-up is +8, +24, +26, +40, +45 and +70 months since ASCT. Of note, survival rate was 74% for the 47 patients receiving HDC and ASCT in first CR (candidated upfront to ASCT due to high-risk IPI at diagnosis) and 62% for the 21 relapsed patients who did not present any of the above mentioned adverse features at relapse. Those two groups were taken from the same initial sample of 146 patients. CONCLUSION: for patients affected by relapsed DLBCL with one or more adverse prognostic features, administration of allogeneic SCT after ASCT as a tandem strategy provides promising results compared with patients receiving ASCT alone and deserves further investigation, especially taking into account the rapid expansion of platforms using T-cell replete haploidentical grafts. Upfront HDC followed by ASCT appears to be a valid option for those patients in PR after first-line therapy, with a 57% survival rate in our series. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Female with Evans Syndrome Presented with Pancytopenia

2021 ◽  
Vol 10 (2) ◽  
pp. 114-117
Author(s):  
Md Rezaul Karim Chowdhury ◽  
Md Haroon Ur Rashid ◽  
Md Mahbub Hossain ◽  
Shafayet Hossain Riyan
Keyword(s):  
Oral Prednisolone ◽  
Low Grade ◽  
Evans Syndrome ◽  
First Line ◽  
Indirect Bilirubin ◽  
First Line Therapy ◽  
Line Therapy ◽  
Immune Neutropenia ◽  
Chronic Course

Evans syndrome is an uncommon haematological disorder characterised by autoimmune haemolytic anaemia (AIHA), immune thrombocytopenia (ITP) and/or immune neutropenia. It may occur in all ethnic groups, all ages and has no sex predilection. The direct antiglobulin test (DAT) is almost invariably positive. This condition generally runs a chronic course and is characterised by frequent exacerbations and remissions. Corticosteroids and/or intravenous immunoglobulin (IVIG) are the most commonly used first line therapy. Here we report a case of a female who presented with severe shortness of breath, palpitation and low grade fever and on examination she was found severely pale and mildly icteric. Her CBC and PBF showed pancytopenia. Indirect bilirubin and LDH were raised and direct Coomb’s test was positive. She was labeled as a case of Evans syndrome and responded to oral prednisolone. On subsequent follow-up her haematological profiles remained normal. J Enam Med Col 2020; 10(2): 114-117

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