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Utility of Single versus Tandem Autotransplants for Advanced Testes/Germ Cell Cancer: A Center for International Blood and Marrow Transplant Research (CIBMTR) Analysis
- Source :
-
Biology of Blood & Marrow Transplantation . Jul2007, Vol. 13 Issue 7, p778-789. 12p. - Publication Year :
- 2007
-
Abstract
- Abstract: Tandem autotransplants are used to treat advanced testis cancer patients but their value compared to a single autotransplant is unknown. To evaluate the results of autotransplant in relapsed testicular/germ cell cancer, data from 300 patients undergoing autotransplants 1989-2002 were reported to the Center for International Blood and Marrow Transplant Research. We compared results for those patients intended to undergo tandem autotransplant procedures (N = 102) versus patients in whom a second autotransplant was not planned (N = 198). Five-year survival probability was 35% (95% confidence interval = 25%-46%) in the planned tandem transplant cohort compared to 42% (35%-49%) in the group not planned to have a second transplant (P = .29). Probability of progression-free survival at 5 years for these cohorts was 34% (25%-44%) and 38% (31%-45%), respectively (P = .50). The planned tandem autotransplant cohort had significantly more advanced disease at diagnosis and greater likelihood of cisplatin resistance. Patients intended to receive tandem transplants had a lower treatment-related mortality at 1 year (3% versus 10%, P = .02). Using propensity score analysis the planned tandem autotransplant cohort had significantly lower treatment-related mortality (P = .044) but no different risk of relapse (P = .541) compared to the planned single transplant cohort. Tandem autotransplants for testicular cancer are associated with less treatment-related mortality than a planned single transplant, with no differences in disease-related outcomes or overall survival at 3 years. Patient selection bias for either transplant approach, however, may affect the results of this observational study; a randomized trial is needed to determine which approach, if either, is better. [Copyright &y& Elsevier]
- Subjects :
- *CANCER patients
*ENDOCRINE glands
*GERMPLASM
*AUTOGRAFTS
Subjects
Details
- Language :
- English
- ISSN :
- 10838791
- Volume :
- 13
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Biology of Blood & Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 25412339
- Full Text :
- https://doi.org/10.1016/j.bbmt.2007.02.013