Long-term disease-free survival in a child with refractory metastatic malignant germ cell tumor treated by high-dose chemotherapy with autologous bone marrow rescues.

We report the case of a 8-month-old girl who presented with a metastatic malignant germ cell tumor (MGCT) that proved to be resistant to chemotherapy, including salvage platinum-based combination therapy, surgery, and metastatectomy. The child was then treated with high-dose carboplatin, etoposide, and cyclophosphamide with autologous bone marrow rescue (ABMR) for two courses, since the first course was well tolerated and resulted in serum alpha-f etoprotein normalisation. The child remains in complete remission 3 years post-ABMR and 4 years post-diagnosis, with no detectable treatment-related sequelae. Thus, as already reported in adults, dose-intensive chemotherapy with ABMR may have curative potential in children with refractory MGCT.