Complete Remission of Progressive SLE after High-dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for Relapsed Non-seminomatous Germ Cell Tumor
|Christos Kosmas1*, Theodora Papachrysanthou1, Theodoros Daladimos1, Nicolas Tsavaris2 and Panayiotis Vlachoyiannopoulos2|
|1 Department of Medicine, 2nd Division of Medical Oncology & Hematopoietic Cell Transplantation Program, “Metaxa” Cancer Hospital, Piraeus, Greece|
|2 Department of Pathophysiology, Oncology Unit, Athens University School of Medicine, Laikon General Hospital, Athens, Greece|
|Corresponding Author :||Christos Kosmas, M.D., Ph.D.
Consultant Medical Oncologist
Department of Medicine
2nd Division of Medical Oncology & Hematopoietic Cell Transplant Program
“Metaxa” Cancer Hospital
51 Botassi Street, Pireaus, Greece
E-mail: [email protected]
|Received: March 03, 2014; Accepted: March 31, 2014; Published: April 07, 2014|
|Citation: Kosmas C, Papachrysanthou T, Daladimos T, Tsavaris N, Vlachoyiannopoulos P (2014) Complete Remission of Progressive SLE after High-dose Chemotherapy and Autologous Hematopoietic Cell Transplantation for Relapsed Non-seminomatous Germ Cell Tumor. J Clin Cell Immunol 5:203. doi:10.4172/2155-9899.1000203|
|Copyright: ©2014 Kosmas C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objective: High dose chemotherapy and hematopoietic stem cell support remains a curative and accepted treatment option for relapsed or non-responsive germ cell tumors, and has been applied experimentally to control severe life-threatening autoimmune diseases.
Case Report: In the present study, we report on a patient with systemic lupus erythematosous nephritis, not controllable with monthly cyclophosphamide pulses followed by immunosuppressive treatment with mycophenolate mofetil, developing a non-seminomatous germ cell tumor that had relapsed after standard chemotherapy and surgery. The patient received salvage chemotherapy with paclitaxel-ifosfamide-cisplatin (TIP) with G-CSF support for three cycles and hematopoietic stem cells were mobilized and harvested with leukapheresis after the first TIP cycle. This was followed by high-dose chemotherapy with carboplatin-etoposide-cyclophosphamide supported by autologous hematopoietic cell transplantation, based on its indication for the relapsed germ-cell tumor, leading to a complete remission of both the neoplastic and autoimmune disease that is sustained for more than 4 years after high-dose chemotherapy.
Conclusion: Prolonged control of his relapsed germ cell tumor and systemic lupus erythematosous was attained with high dose chemotherapy and hematopoietic stem cell support. An extensive literature review is provided besides a detailed discussion of the above case.