Hematologic Disorders Associated With Primary Mediastinal Nonseminomatous Germ Cell Tumors

Hartmann, Jörg T.; Nichols, Craig R.; Droz, J. P.; Horwich, A.; Gerl, Arthur; Fosså, Sophie D.; Beyer, Jörg; Pont, Jörg; Fizazi, Karim; Einhorn, Lawrence; Kanz, Lothar; Bokemeyer, Carsten

doi:10.1093/jnci/92.1.54

Cited by 177 publications

(155 citation statements)

References 44 publications

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…As first reported by Nichols et al, 25 associated syndromes such as hematologic malignancies (e.g., leukemia or myelodysplastic syndrome) may have an impact on prognosis. Hartman et al 26 reported that hematologic disorders occurred in 17 of 287 (5.9%) patients with mediastinal NSGCT, whereas no cases were seen in another 334 extragonadal NSGCT cases. In addition, NSGCT is occasionally associated with Klinfelter syndrome.…”

Section: Nsgctmentioning

confidence: 99%

Primary germ cell tumors in the mediastinum

Takeda

Miyoshi

Ohta

et al. 2003

Cancer

184

View full text Add to dashboard Cite

Liquid fraction profiles of a column of draining aqueous foam stabilized with sodium dodecyl sulfate were studied by nuclear magnetic resonance imaging (NMRI) at high spatial and temporal resolution. It was observed that the liquid holdup in the column is not locally homogeneous in the direction of the column axis with liquid holdup exhibiting periodic variation in time. This creates “ripples” in the liquid content profiles (that is, an approximately sinusoidal variation of liquid fraction in space). These ripples are seen to actually rise in the column as liquid drains down through the foam. This behavior may be explained by a simple mass balance: the rising velocity of the ripples multiplied by the gas fraction in the foam is equivalent to the liquid superficial drainage rate. Thus, NMRI is proposed as a powerful tool for studying drainage of foams because it provides a noninvasive method of measuring superficial drainage rate in foams that yields time‐resolved instantaneous drainage rates as a function of position in the column. The measured liquid drainage rates were compared with a dimensionless expression for the liquid drainage rate and excellent agreement was achieved. © 2006 American Institute of Chemical Engineers AIChE J, 2007

show abstract

Section: Nsgctmentioning

confidence: 99%

Primary germ cell tumors in the mediastinum

Takeda

Miyoshi

Ohta

et al. 2003

Cancer

184

View full text Add to dashboard Cite

show abstract

“…Furthermore, mediastinal nonseminomatous tumors are associated with Klinefelter's syndrome and hematological malignancy. 4,5) Cisplatin-containing chemotherapy dramatically improved the outlook for patients with GCT in the 1970s. The International Germ Cell Cancer Collaborative Group (IGCCCG) has proposed a staging classification based on prognostic factors for patients with metastatic GCT who were treated with cisplatin-containing chemotherapy.…”

mentioning

confidence: 99%

Extragonadal germ cell tumors in Japan

Ebi¹,

Nakata²,

Tahara³

et al. 2003

Cancer Science

View full text Add to dashboard Cite

Extragonadal germ cell tumors (EGCT) represent only 2-5% of adult germ cell malignancies. Some publications from Asia have reported inferior treatment outcomes compared to data from an international study group. To ascertain whether this is generally the case, here we analyze treatment outcomes for 30 Japanese patients with EGCT. The medical records of 30 patients (25 nonseminomas and 4 pure seminomas) treated from 1992 to 2002 were reviewed retrospectively. All patients with seminoma achieved long survival except one who died of chemotherapy-related sepsis. Ten and 11 patients with EGCT presented with mediastinal and retroperitoneal primary sites, respectively. The 5-year overall survival (OS) and progression-free survival (PFS) for nonseminoma was 71% and 42%, respectively. The 5-year OS and PFS was 60% and 44%, respectively, for 10 patients with mediastinal nonseminoma, and 91% and 48%, respectively, for patients with retroperitoneal nonseminoma. Tumor marker values on day 7 were available for 19 patients. Among the 19 patients in whom AFP or β β β β-HCG were measured on day 7, the values had declined in 12 patients and were transiently elevated in 7 patients compared to pretreatment values. The transient elevations of tumor markers were significantly associated with poor OS (P = = = =0.02) and PFS (P = = = =0.008). The treatment outcome of Japanese patients with EGCT seemed to be comparable to that reported from international studies, suggesting no difference between ethnic groups. Transient tumor marker elevations on day 7 predict poor survival in EGCT patients and may be a useful parameter for identifying patients requiring more aggressive treatment. (Cancer Sci 2003; 94: 1107-1111) erm cell tumors (GCT) predominantly arise in the testes, but a small subset of 2 to 5% is of extragonadal origin. 1)Extragonadal germ cell tumors (EGCT) usually present in midline structures, such as the anterior mediastinum, the retroperitoneum, and the pineal gland, but occasionally arise in the lung or upper gastrointestinal tract. 2, 3)Extragonadal germ cell tumors differ from GCTs of testicular origin in several ways. First, the distribution of histological subtypes presented in adult EGCTs is different from that of testicular EGCTs. Second, patients with EGCTs usually present with far more advanced disease than those with primary testicular tumors. Furthermore, mediastinal nonseminomatous tumors are associated with Klinefelter's syndrome and hematological malignancy. 4,5) Cisplatin-containing chemotherapy dramatically improved the outlook for patients with GCT in the 1970s. The International Germ Cell Cancer Collaborative Group (IGCCCG) has proposed a staging classification based on prognostic factors for patients with metastatic GCT who were treated with cisplatin-containing chemotherapy.6) Because of the rarity of this disease, only limited data had been available regarding the clinical course of EGCTs, [7][8][9][10] prior to a recent report from an international study group on the characteristics and prognostic variabl...

show abstract

“…Accordingly, the presence of a mediastinal primary tumour in patients with nonseminomatous GCT was identified as a major adverse prognostic factor by the IGCCCG. Such patients appear to represent a clinically and biologically distinct disease entity (Nichols et al, 1985(Nichols et al, , 1987(Nichols et al, , 1990aHartmann et al, 2000b, (Saxman et al, 1994, Loehrer et al, 1998Hartmann et al, 2001a). Historically, the incorporation of cisplatin into chemotherapy regimens has yielded survival rates of approximately 30 -40% in retrospective analyses (Garnick et al, 1983;Logothetis et al, 1985;Delgado et al, 1993;Dulmet et al, 1993;Toner et al, 1991; International germ cell consensus classification, 1997).…”

Section: Discussionmentioning

confidence: 99%

“…As described before, there is approximately a 6% risk to develop a haematologic disorder in patients with primary mediastinal nonseminoma, which represents a biological phenomenon not related to chemotherapy (Nichols et al, 1985(Nichols et al, , 1990aHartmann et al, 2000b). The haematologic malignancies have a very aggressive clinical course with patients either dying before treatment, not responding to antileukaemic therapy, or achieving remissions of very short duration.…”

mentioning

confidence: 96%

First-line sequential high-dose VIP chemotherapy with autologous transplantation for patients with primary mediastinal nonseminomatous germ cell tumours: a prospective trial

et al. 2003

View full text Add to dashboard Cite

To determine the efficacy of first-line sequential high-dose VIP chemotherapy (HD-VIP) in patients with primary mediastinal nonseminomatous germ cell tumours (GCT), 28 patients were enrolled on a German multicentre trial. High-Dose VIP chemotherapy consisted of 3 -4 cycles of dose-intensive etoposide and ifosfamide plus cisplatin, q22days, each cycle followed by autologous peripheral blood stem cell transplantation plus granulocyte-colony stimulating factor (G-CSF) support. One cycle of standard-dose VIP was applied to harvest peripheral blood stem cells. Ten patients had mediastinal involvement as the only manifestation (36 %), 18 of 28 patients had additional metastatic sites, such as lung (n ¼ 17; 61%), liver (n ¼ 7; 25%), bone (n ¼ 5; 18%), lymph nodes (n ¼ 3; 11%) and CNS (n ¼ 3; 11%). Median follow-up was 43 months (range, 7 -113) for all patients and 52 months (range, 22 -113) for surviving patients. Nineteen of 28 patients obtained a disease-free status; 11 with HD-VIP alone and eight with adjunctive surgery. In addition, one of the four patients with marker negative partial remission after HD-VIP without resection of residual masses is currently alive. Two patients developed recurrence of GCT or teratoma. Two patients have died due to an associated haematologic disorder. The 2-year progression-free survival and overall survival rates are 64 and 68%, respectively. This report represents a subgroup analysis of 28 patients with mediastinal nonsemina within the German first-line study for 'poor prognosis' GCT. Compared to data of an international database analysis including 253 patients with mediastinal nonseminoma treated with conventional chemotherapy, the results may indicate that HD-VIP results in an approximately 15% survival improvement.

show abstract

Hematologic Disorders Associated With Primary Mediastinal Nonseminomatous Germ Cell Tumors

Cited by 177 publications

References 44 publications

Primary germ cell tumors in the mediastinum

Primary germ cell tumors in the mediastinum

Extragonadal germ cell tumors in Japan

First-line sequential high-dose VIP chemotherapy with autologous transplantation for patients with primary mediastinal nonseminomatous germ cell tumours: a prospective trial

Contact Info

Product

Resources

About