Hematopoietic stem cell transplantation for hematological neoplasia associated with primary mediastinal germ cell tumor

Tatsuro Nakanishi; Maho Sato; Kazuyuki Shiomi; Akitaka Nomura; Takashi Ishihara; Tiyoshi Toyama; Aya Ioi; Kohei Higuchi; Mariko Shimizu; Akihisa Sawada; Masahiro Yasui; Keiko Matsuoka; Makoto Takeuchi; Yoshiro Usui; Masami Inoue

doi:10.11412/jspho.56.353

Case Report

Hematopoietic stem cell transplantation for hematological neoplasia associated with primary mediastinal germ cell tumor

Tatsuro Nakanishi, Maho Sato, Kazuyuki Shiomi, Akitaka Nomura, Takashi Ishihara, Tiyoshi Toyama, Aya Ioi, Kohei Higuchi, Mariko Shimizu, Akihisa Sawada, Masahiro Yasui, Keiko Matsuoka, Makoto Takeuchi, Yoshiro Usui, Masami Inoue

Author information

Tatsuro Nakanishi
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Maho Sato
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Kazuyuki Shiomi
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Akitaka Nomura
Department of Pediatrics, Nara Medical University
Takashi Ishihara
Department of Pediatrics, Nara Medical University
Tiyoshi Toyama
Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
Aya Ioi
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Kohei Higuchi
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Mariko Shimizu
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Akihisa Sawada
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Masahiro Yasui
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Keiko Matsuoka
Department of Diagnostic Pathology, Osaka Women’s and Children’s Hospital
Makoto Takeuchi
Department of Diagnostic Pathology, Osaka Women’s and Children’s Hospital
Yoshiro Usui
Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
Masami Inoue
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital

Keywords: germ cell tumor, acute megakaryoblastic leukemia, hematological neoplasia associated with primary mediastinal germ cell tumor, hematopoietic stem cell transplantation

JOURNAL FREE ACCESS

2019 Volume 56 Issue 3 Pages 353-357

DOI https://doi.org/10.11412/jspho.56.353

Details

Abstract

A 14-year-old male was referred to his previous doctor for fever and lumbago. A germ cell tumor (GCT) was observed in the mediastinum complicated by acute megakaryoblastic leukemia (AMKL). On the basis of this rare complication, the patient was diagnosed as having hematological neoplasia associated with primary mediastinal germ cell tumor (HN-PMGCT). He was treated following the JPLSG AML12 protocol for induction chemotherapy and achieved complete remission. His intensive chemotherapy included cisplatin to increase its effectiveness for the GCT, but after the 2^nd cycle of intensive chemotherapy, AMKL relapsed and the GCT increased in size, causing dyspnea. To perform advanced therapy, he was transferred to our center. His GCT was resected, and hematopoietic stem cell transplantation (HSCT) was performed immediately after. However, HN-PMGCT recurred in the CNS and marrow approximately one month after the HSCT, resulting in death 117 days after the procedure. This syndrome needs to be studied further to develop new effective treatments.

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