Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades

Deepak Kilari; Anita D'Souza; Raphael Fraser; Muna Qayed; Omar Davila; Vaibhav Agrawal; Miguel Angel Diaz; Saurabh Chhabra; Jan Cerny; Edward Copelan; Nosha Farhadfar; Cesar O. Freytes; Robert Peter Gale; Siddhartha Ganguly; Gerhard C. Hildebrandt; Leona Holmberg; Rammurti T. Kamble; Prashant Kapoor; Hillard Lazarus; Cindy Lee; Hemant S. Murthy; Seema Naik; Taiga Nishihori; Ayman Saad; Bipin N. Savani; Sachiko Seo; Anne Warwick; Baldeep Wirk; Jean A. Yared; Yago Nieto; Parameswaran Hari

doi:10.1016/j.bbmt.2019.02.015

Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades

Deepak Kilari, Anita D'Souza, Raphael Fraser, Muna Qayed, Omar Davila, Vaibhav Agrawal, Miguel Angel Diaz, Saurabh Chhabra, Jan Cerny, Edward Copelan, Nosha Farhadfar, Cesar O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Gerhard C. Hildebrandt, Leona Holmberg, Rammurti T. Kamble, Prashant Kapoor, Hillard Lazarus, Cindy LeeHemant S. Murthy, Seema Naik, Taiga Nishihori, Ayman Saad, Bipin N. Savani, Sachiko Seo, Anne Warwick, Baldeep Wirk, Jean A. Yared, Yago Nieto, Parameswaran Hari

Internal Medicine

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

The curative potential of autologous hematopoietic cell transplantation (autoHCT) for male germ cell tumors (GCTs) is well established. The optimal timing and number (single transplant [ST] versus tandem transplants [TT] versus triple transplants) of autoHCT are controversial, with wide practice variations. We examined survival trends among 2395 recipients of autoHCT for male GCTs between 1990 and 2015 reported to the Center for International Blood and Marrow Transplant Research. Trends and outcomes were analyzed by year of transplantation for intervals 1990 to 1994 (N = 288), 1995 to 1999 (N = 351), 2000 to 2004 (N = 376), 2005 to 2009 (N = 509), and 2010 to 2015 (N = 871). Multivariate analysis was restricted to the subset from 2000 to 2015 with research-level data (n = 267). The median duration of follow-up was 51 months. The median age at autoHCT was 31 years; 633 patients (26%) had primary extragonadal GCT, and 1167 (49%) underwent TT. The 3-year progression-free (PFS) and overall survival (OS) improved from 24% (95% confidence interval [CI], 18% to 31%) and 35% (95% CI, 29% to 40%), respectively, in 1990 to 1994 to 47% (95% CI, 43% to 50%) and 54% (95% CI, 50% to 57%), respectively, in 2010 to 2015 (P < .0001). TT recipients were more likely than ST recipients to undergo autoHCT as first salvage treatment. The proportion of TTs increased from 38% of all autoHCTs in 2000 to 2004 to 77% in 2010 to 2015. Nonseminoma histology, residual disease at autoHCT, >1 line of pretransplantation chemotherapy, and ST versus TT were associated with inferior PFS and OS. Post-transplantation survival has improved significantly over time for relapsed/refractory male GCT and is associated with the increased use of TTs (compared with STs) and performance of autoHCT earlier in the disease course.

Original language	English
Pages (from-to)	1099-1106
Number of pages	8
Journal	Biology of Blood and Marrow Transplantation
Volume	25
Issue number	6
DOIs	https://doi.org/10.1016/j.bbmt.2019.02.015
State	Published - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019

Funding

The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 4U10HL069294 from the NHLBI and NCI; Contract HHSH25020170006C with the Health Resources and Services Administration; Grants N00014-17-1-2388 and N0014-17-1-2850 from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, *Amgen, *Amneal Biosciences; *Angiocrine Bioscience, anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be the Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene, Cerus, *Chimerix, Fred Hutchinson Cancer Research Center, Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, *Incyte, Janssen Scientific Affairs, *Jazz Pharmaceuticals, Juno Therapeutics, Karyopharm Therapeutics, Kite Pharma, Medac, MedImmune, The Medical College of Wisconsin, *Mediware, *Merck & Co, *Mesoblast, MesoScale Diagnostics, Millennium, the Takeda Oncology Co, *Miltenyi Biotec, National Marrow Donor Program, *Neovii Biotech NA, Novartis Pharmaceuticals, Otsuka Pharmaceutical, PCORI, *Pfizer, *Pharmacyclics, PIRCHE, *Sanofi Genzyme, *Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, *Sunesis Pharmaceuticals, Swedish Orphan Biovitrum, Takeda Oncology, Telomere Diagnostics, and the University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government. *Corporate member. Conflicts of Interest statement: There are no conflicts of interest to report. Financial disclosure: See Acknowledgments on page 1105. The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases ; Grant/Cooperative Agreement 4U10HL069294 from the NHLBI and NCI; Contract HHSH25020170006C with the Health Resources and Services Administration; Grants N00014-17-1-2388 and N0014-17-1-2850 from the Office of Naval Research ; and grants from *Actinium Pharmaceuticals, *Amgen, *Amneal Biosciences; *Angiocrine Bioscience, anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be the Match Foundation, *bluebird bio, *Bristol Myers Squibb Oncology, *Celgene, Cerus, *Chimerix, Fred Hutchinson Cancer Research Center, Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, *Incyte, Janssen Scientific Affairs, *Jazz Pharmaceuticals, Juno Therapeutics, Karyopharm Therapeutics, Kite Pharma, Medac, MedImmune, The Medical College of Wisconsin, *Mediware, *Merck & Co, *Mesoblast, MesoScale Diagnostics, Millennium, the Takeda Oncology Co, *Miltenyi Biotec, National Marrow Donor Program, *Neovii Biotech NA, Novartis Pharmaceuticals, Otsuka Pharmaceutical, PCORI, *Pfizer, *Pharmacyclics, PIRCHE, *Sanofi Genzyme, *Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, *Sunesis Pharmaceuticals, Swedish Orphan Biovitrum, Takeda Oncology, Telomere Diagnostics, and the University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government.

Funders	Funder number
Amneal Biosciences, *Angiocrine Bioscience
Angiocrine Bioscience
Bristol Myers Squibb Oncology
Department of the Navy
US Government Accountability Office
National Institutes of Health (NIH)
U.S. Department of Defense
Office of Naval Research
National Heart, Lung, and Blood Institute (NHLBI)	U01HL069294
National Childhood Cancer Registry – National Cancer Institute
National Institute of Allergy and Infectious Diseases	HHSH25020170006C
Health Resources and Services Administration	N00014-17-1-2388, N0014-17-1-2850
Patient-Centered Outcomes Research Institute
Minnesota State University-Mankato
Novartis Pharmaceuticals Corporation
Otsuka America Pharmaceutical
Actinium Pharmaceuticals Incorporated
Angiocrine Bioscience
Otsuka Pharmaceutical Co Ltd.

Keywords

Autologous
Germ cell cancers
Transplantation

ASJC Scopus subject areas

Hematology
Transplantation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.bbmt.2019.02.015

Cite this

Kilari, D., D'Souza, A., Fraser, R., Qayed, M., Davila, O., Agrawal, V., Diaz, M. A., Chhabra, S., Cerny, J., Copelan, E., Farhadfar, N., Freytes, C. O., Gale, R. P., Ganguly, S., Hildebrandt, G. C., Holmberg, L., Kamble, R. T., Kapoor, P., Lazarus, H., ... Hari, P. (2019). Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades. Biology of Blood and Marrow Transplantation, 25(6), 1099-1106. https://doi.org/10.1016/j.bbmt.2019.02.015

@article{f1c082959a3f46469f8ee97f8f0695a6,

title = "Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades",

abstract = "The curative potential of autologous hematopoietic cell transplantation (autoHCT) for male germ cell tumors (GCTs) is well established. The optimal timing and number (single transplant [ST] versus tandem transplants [TT] versus triple transplants) of autoHCT are controversial, with wide practice variations. We examined survival trends among 2395 recipients of autoHCT for male GCTs between 1990 and 2015 reported to the Center for International Blood and Marrow Transplant Research. Trends and outcomes were analyzed by year of transplantation for intervals 1990 to 1994 (N = 288), 1995 to 1999 (N = 351), 2000 to 2004 (N = 376), 2005 to 2009 (N = 509), and 2010 to 2015 (N = 871). Multivariate analysis was restricted to the subset from 2000 to 2015 with research-level data (n = 267). The median duration of follow-up was 51 months. The median age at autoHCT was 31 years; 633 patients (26%) had primary extragonadal GCT, and 1167 (49%) underwent TT. The 3-year progression-free (PFS) and overall survival (OS) improved from 24% (95% confidence interval [CI], 18% to 31%) and 35% (95% CI, 29% to 40%), respectively, in 1990 to 1994 to 47% (95% CI, 43% to 50%) and 54% (95% CI, 50% to 57%), respectively, in 2010 to 2015 (P < .0001). TT recipients were more likely than ST recipients to undergo autoHCT as first salvage treatment. The proportion of TTs increased from 38% of all autoHCTs in 2000 to 2004 to 77% in 2010 to 2015. Nonseminoma histology, residual disease at autoHCT, >1 line of pretransplantation chemotherapy, and ST versus TT were associated with inferior PFS and OS. Post-transplantation survival has improved significantly over time for relapsed/refractory male GCT and is associated with the increased use of TTs (compared with STs) and performance of autoHCT earlier in the disease course.",

keywords = "Autologous, Germ cell cancers, Transplantation",

author = "Deepak Kilari and Anita D'Souza and Raphael Fraser and Muna Qayed and Omar Davila and Vaibhav Agrawal and Diaz, {Miguel Angel} and Saurabh Chhabra and Jan Cerny and Edward Copelan and Nosha Farhadfar and Freytes, {Cesar O.} and Gale, {Robert Peter} and Siddhartha Ganguly and Hildebrandt, {Gerhard C.} and Leona Holmberg and Kamble, {Rammurti T.} and Prashant Kapoor and Hillard Lazarus and Cindy Lee and Murthy, {Hemant S.} and Seema Naik and Taiga Nishihori and Ayman Saad and Savani, {Bipin N.} and Sachiko Seo and Anne Warwick and Baldeep Wirk and Yared, {Jean A.} and Yago Nieto and Parameswaran Hari",

note = "Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = jun,

doi = "10.1016/j.bbmt.2019.02.015",

language = "English",

volume = "25",

pages = "1099--1106",

number = "6",

}

Kilari, D, D'Souza, A, Fraser, R, Qayed, M, Davila, O, Agrawal, V, Diaz, MA, Chhabra, S, Cerny, J, Copelan, E, Farhadfar, N, Freytes, CO, Gale, RP, Ganguly, S, Hildebrandt, GC, Holmberg, L, Kamble, RT, Kapoor, P, Lazarus, H, Lee, C, Murthy, HS, Naik, S, Nishihori, T, Saad, A, Savani, BN, Seo, S, Warwick, A, Wirk, B, Yared, JA, Nieto, Y & Hari, P 2019, 'Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades', Biology of Blood and Marrow Transplantation, vol. 25, no. 6, pp. 1099-1106. https://doi.org/10.1016/j.bbmt.2019.02.015

TY - JOUR

T1 - Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors

T2 - Improved Outcomes Over 3 Decades

AU - Kilari, Deepak

AU - D'Souza, Anita

AU - Fraser, Raphael

AU - Qayed, Muna

AU - Davila, Omar

AU - Agrawal, Vaibhav

AU - Diaz, Miguel Angel

AU - Chhabra, Saurabh

AU - Cerny, Jan

AU - Copelan, Edward

AU - Farhadfar, Nosha

AU - Freytes, Cesar O.

AU - Gale, Robert Peter

AU - Ganguly, Siddhartha

AU - Hildebrandt, Gerhard C.

AU - Holmberg, Leona

AU - Kamble, Rammurti T.

AU - Kapoor, Prashant

AU - Lazarus, Hillard

AU - Lee, Cindy

AU - Murthy, Hemant S.

AU - Naik, Seema

AU - Nishihori, Taiga

AU - Saad, Ayman

AU - Savani, Bipin N.

AU - Seo, Sachiko

AU - Warwick, Anne

AU - Wirk, Baldeep

AU - Yared, Jean A.

AU - Nieto, Yago

AU - Hari, Parameswaran

PY - 2019/6

Y1 - 2019/6

N2 - The curative potential of autologous hematopoietic cell transplantation (autoHCT) for male germ cell tumors (GCTs) is well established. The optimal timing and number (single transplant [ST] versus tandem transplants [TT] versus triple transplants) of autoHCT are controversial, with wide practice variations. We examined survival trends among 2395 recipients of autoHCT for male GCTs between 1990 and 2015 reported to the Center for International Blood and Marrow Transplant Research. Trends and outcomes were analyzed by year of transplantation for intervals 1990 to 1994 (N = 288), 1995 to 1999 (N = 351), 2000 to 2004 (N = 376), 2005 to 2009 (N = 509), and 2010 to 2015 (N = 871). Multivariate analysis was restricted to the subset from 2000 to 2015 with research-level data (n = 267). The median duration of follow-up was 51 months. The median age at autoHCT was 31 years; 633 patients (26%) had primary extragonadal GCT, and 1167 (49%) underwent TT. The 3-year progression-free (PFS) and overall survival (OS) improved from 24% (95% confidence interval [CI], 18% to 31%) and 35% (95% CI, 29% to 40%), respectively, in 1990 to 1994 to 47% (95% CI, 43% to 50%) and 54% (95% CI, 50% to 57%), respectively, in 2010 to 2015 (P < .0001). TT recipients were more likely than ST recipients to undergo autoHCT as first salvage treatment. The proportion of TTs increased from 38% of all autoHCTs in 2000 to 2004 to 77% in 2010 to 2015. Nonseminoma histology, residual disease at autoHCT, >1 line of pretransplantation chemotherapy, and ST versus TT were associated with inferior PFS and OS. Post-transplantation survival has improved significantly over time for relapsed/refractory male GCT and is associated with the increased use of TTs (compared with STs) and performance of autoHCT earlier in the disease course.

AB - The curative potential of autologous hematopoietic cell transplantation (autoHCT) for male germ cell tumors (GCTs) is well established. The optimal timing and number (single transplant [ST] versus tandem transplants [TT] versus triple transplants) of autoHCT are controversial, with wide practice variations. We examined survival trends among 2395 recipients of autoHCT for male GCTs between 1990 and 2015 reported to the Center for International Blood and Marrow Transplant Research. Trends and outcomes were analyzed by year of transplantation for intervals 1990 to 1994 (N = 288), 1995 to 1999 (N = 351), 2000 to 2004 (N = 376), 2005 to 2009 (N = 509), and 2010 to 2015 (N = 871). Multivariate analysis was restricted to the subset from 2000 to 2015 with research-level data (n = 267). The median duration of follow-up was 51 months. The median age at autoHCT was 31 years; 633 patients (26%) had primary extragonadal GCT, and 1167 (49%) underwent TT. The 3-year progression-free (PFS) and overall survival (OS) improved from 24% (95% confidence interval [CI], 18% to 31%) and 35% (95% CI, 29% to 40%), respectively, in 1990 to 1994 to 47% (95% CI, 43% to 50%) and 54% (95% CI, 50% to 57%), respectively, in 2010 to 2015 (P < .0001). TT recipients were more likely than ST recipients to undergo autoHCT as first salvage treatment. The proportion of TTs increased from 38% of all autoHCTs in 2000 to 2004 to 77% in 2010 to 2015. Nonseminoma histology, residual disease at autoHCT, >1 line of pretransplantation chemotherapy, and ST versus TT were associated with inferior PFS and OS. Post-transplantation survival has improved significantly over time for relapsed/refractory male GCT and is associated with the increased use of TTs (compared with STs) and performance of autoHCT earlier in the disease course.

KW - Autologous

KW - Germ cell cancers

KW - Transplantation

UR - http://www.scopus.com/inward/record.url?scp=85064954131&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064954131&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2019.02.015

DO - 10.1016/j.bbmt.2019.02.015

M3 - Article

C2 - 30794931

AN - SCOPUS:85064954131

SN - 1083-8791

VL - 25

SP - 1099

EP - 1106

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 6

ER -

Autologous Hematopoietic Stem Cell Transplantation for Male Germ Cell Tumors: Improved Outcomes Over 3 Decades

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this