Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001) and disease-free survival rates were 83%, 34% and 7% ( P < 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001), the initial stage of disease ( P < 0.001), the initial serum AFP level (p: 0.001), the initial β -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P < 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001) and disease-free survival rates were 83%, 34% and 7% ( P < 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001), the initial stage of disease ( P < 0.001), the initial serum AFP level (p: 0.001), the initial β -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P < 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P &lt; 0.001) and disease-free survival rates were 83%, 34% and 7% ( P &lt; 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P &lt; 0.001), the initial stage of disease ( P &lt; 0.001), the initial serum AFP level (p: 0.001), the initial \u3b2 -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P &lt; 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

Comparison of engraftment in patients undergoing peripheral blood stem call transplantation (PBSCT) with or without support of G-CSF on day +5: A prospective cohort study results

17521 Background: The role of G-CSF administration on day +5 after PBSCT in terms of hematologic engraftment and supportive treatment need has been evaluated. Methods: Forty-two consecutive patients with solid and hematological malignancies were enrolled in two cohort groups depending on G-CSF administration. Twenty-seven patients were given G-CSF (5 μg/kg/day) from day +5 after the transplantation until the achievement of neutrophil engraftment. Posttransplant G-CSF was not given to the control arm of 15 patients. A number of at least 2 × 106 CD34+ cells per kilogram collected by cytapheresis were given to all patients. Results: A significant difference was found between the two groups in favor of G-CSF receiving group, in terms of neutrophil engraftment time (10.56 ± 1.22 vs 11.93 ± 2.89 day; p = 0.04), number of days with fever (3.33 ± 2.66 vs 5 ± 2.95 day; p = 0,03) and number of the days requiring antibiotic therapy (7.07 ± 3.46 vs 11.87 ± 3.74 day; p &lt; 0,001); whereas, no statistically significant difference was noted in terms of hospitalization period (13.30 ± 4.79 and 13.53 ± 2.56 day; p = 0.26), platelet engraftment time (12.22 ± 2.79 and 13.40 ± 3.89 day; p = 0.26) and erythrocyte transfusion need; however, platelet transfusion need was statistically significant between the groups with and without G-CSF support (1.27 ± 0.96 vs 0.56 ± 0.75, p = 0.01) Conclusions: This study reveal that starting G-CSF on day +5 may fasten the neutrophil engraftment, decrease the number of days with fever, as well as a the need for antibiotic therapy in posttransplant period. No significant financial relationships to disclose. </jats:p

Outcome of patients with stage II and III nonseminomatous germ cell tumors: Results of a single center

Background: The prognostic factors in nonseminomatous germ cell tumors have been mainly derived from the analysis of stage I tumors. Aims: The aim of this study was to evaluate some prognostic factors and the outcome of patients with stage II and III nonseminomatous germ cell tumors according to risk groups treated between 1993 and 2002. Settings and Design: Patients were retrospectively classified as good, intermediate and poor risk groups according to International Germ Cell Cancer Consensus Group. Materials and Methods: Biopsy specimens of 58 patients with stage II and III nonseminomatous germ cell tumors were analyzed by means of tumor histopathology, primary localization site of the tumor, relapse sites, initial serum tumor marker levels, the presence of persistent serum tumor marker elevation and the patients' outcome. Statistical Analysis : Kruskall Wallis test and Mann-Whitney U test were used to determine the differences between the groups. Kaplan-Meier method was used for survival analysis and log rank test was used to compare the survival probabilities of groups. Cox proportional hazard analysis was used to determine the prognostic factors in univariate and multivariate analysis. Results: Five-year overall and disease-free survival rates were calculated as 85% and 75% in stage II; 44% and 29% in stage III cases, respectively. Fifty-seven percent of patients were classified in good risk, 9% in intermediate risk and 27% in poor risk groups. Five-year overall survival rates were 97%, 75% and 7% ( P < 0.001) and disease-free survival rates were 83%, 34% and 7% ( P < 0.001) in good, intermediate and poor risk groups, respectively. Analysis of the prognostic factors revealed that the localization site of the primary tumor ( P < 0.001), the initial stage of disease ( P < 0.001), the initial serum AFP level (p: 0.001), the initial β -HCG level (p: 0.0048), the presence of yolk sac and choriocarcinoma components in tumor (p: 0.003 and p: 0.004), relapse sites of tumor (lung versus other than lung) (p: 0.003), persistent elevation of serum tumor markers ( P < 0.001) were significant prognostic factors in univariate analysis. However, in multivariate analysis, only the localization site of tumor (p: 0.049) and the relapse site (p: 0.003) were found statistically significant. Conclusions: This retrospective study revealed that in advanced stage of nonseminomatous germ cell tumors, the outcome is essentially related with the localization site of the tumor and the relapse site

Donor cell leukemia in a patient developing 11 months after an allogeneic bone marrow transplantation for chronic myeloid leukemia

A 38‐year‐old female with chronic myeloid leukemia underwent an allogeneic bone marrow transplantation from her full‐matched brother. Eleven months later, she readmitted with an acute leukemia that was shown to be of donor origin. The patient never achieved a remission even after chemotherapies with cytarabine and mitoxantrone, donor lymphocyte infusion, and second allogeneic peripheral blood stem cell transplantation. Donor cell leukemia (DCL) is sometimes misdiagnosed as relapse by clinicians and the real incidence may be higher than expected. Cytogenetic and molecular techniques may be helpful to clarify the issue of the leukemia. The current case is another case of DCL reported in the literature after an allogeneic transplant for a kind of leukemia. Am. J. Hematol. 81:370–373, 200

The autologous hematopoietic stem cell transplantation in adult patients with lymphoma: Turkish Bone Marrow Transplantation Registry results

Turkish Bone Marrow Transplantation Registry (TBMTR) was established in 1995. Since 1992, data of adult lymphoma patients from fifteen national transplantation centers were collected and analyzed by TBMTR. A total of 437 adult lymphoma patients (185 Hodgkin's and 252 non-Hodgkin's lymphoma) undergoing autologous hematopoietic stem cell transplantation (HSCT) were registered in TBMTR from 1992 to 2002. Peripheral blood as stem cell source was used in 94% of the transplantations. Non-TBI (total body irradiation) conditioning regimens were administered in 88% of the cases. The 100-day transplantation-related mortality (TRM) was 11% in relapsed and 11% in primary refractory Hodgkin's lymphoma patients whilst TRM was found to be 9% and 30% in non-Hodgkin's lymphoma patients in first remission and in primary refractory cases, respectively. Infection was the most common cause of TRM. 10-year and 5-year survival rates were 50% and 49% in relapsed cases and primary refractory cases with Hodgkin's lymphoma, respectively; while in non-Hodgkin's lymphoma patients 10-year survival rate was 65% in cases in first remission, 7-year survival rate was 50% in sensitive relapse, 2-year survival rate was 0% in resistant relapse and 3-year survival was 24% in primary refractory cases. In conclusion, TBMTR results are comparable to EBMT and IBMTR results. Therefore, autologous HSCT may provide long-term survival in patients with Hodgkin's lymphoma as well as in patients with non-Hodgkin lymphoma in first remission and in sensitive relapse