A case of successful use of a tandem regimen of high-dose polychemotherapy followed by autologous hematopoietic stem cell transplantation in a child with a refractory form of germ cell tumor

Germ cell tumors (GCTs) are a heterogeneous group of tumors that develop from pluripotent germ cells, diagnosed most often in infants, young children, adolescents and young adults, and are characterized by different localization, histological picture, clinical course and prognosis. Despite the fairly high efficiency of modern standard chemotherapy protocols for GCTs, the treatment of their relapses and refractory forms, which make up to 30–40 % of all GCTs and have an extremely unfavorable prognosis, is very difficult. Currently, there is no single strategy for the treatment of relapses and refractory forms of GCTs, however, the world and domestic literature presents data on the successful use of high-dose chemotherapy (HDCT) in such patients followed by autologous hematopoietic stem cell transplantation (auto-HSCT). To develop and optimize protocols for this therapy method, and therefore improve the treatment outcomes for patients with relapses and refractory forms of GCT, it is necessary to analyze a larger number of studies from various transplant centers working in this area. The article presents current literature data on the use of HDCT followed by auto-HSCT in patients with GCT, as well as a clinical case of successful 2 courses of HDCT with auto-HSCT in tandem mode in a child with a refractory form of GCT with subsequent maintenance of complete remission for 2 years.