Prognostic factors for patients with relapsed central nervous system nongerminomatous germ cell tumors

Mohammad H. Abu-Arja, Diana S. Osorio, Alvaro Lassaletta, Richard T. Graham, Scott L. Coven, Joseph R. Stanek, Eric Bouffet, Jonathan L. Finlay, Mohamed S. Abdelbaki

Research output: Contribution to journalReview articlepeer-review

Abstract

We aimed toidentify prognostic factors that may help better understand the behavior of relapsed central nervous system nongerminomatous germ cell tumors. We identified nine studies, including 101 patients; 33 patients (33%) were alive 12 months post-initial relapse. Sixty percent of patients with serum/cerebrospinal fluid (CSF) alpha-fetoprotein (AFP) level ≤25 ng/mL at initial diagnosis were survivors compared with 28% among patients with serum/CSF AFP level >25 ng/mL (P = 0.01). Seventy-one percent of patients who achieved complete response/continued complete response (CR/CCR) by the end of therapy at relapse were survivors compared with 7% among patients who had less than CR/CCR (P < 0.0001). Forty-eight percent of patients who received marrow-ablative chemotherapy followed by autologous hematopoietic cell rescue (HDCx/AuHCR) following relapse were survivors compared with 12% among patients who did not receive HDCx/AuHCR (P = 0.0001). Local relapse site, gross total surgical resection, and radiotherapy at relapse were not associated with improved outcomes.

Original languageEnglish
Article numbere29365
JournalPediatric Blood and Cancer
Volume69
Issue number1
DOIs
StatePublished - Jan 2022

Keywords

  • Central nervous system
  • germ cell tumors
  • nongerminomatous germ cell tumors
  • recurrence
  • relapse

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