Pediatric Extracranial Germ Cell Tumors: Review of Clinics and Perspectives in Application of Autologous Stem Cell Transplantation

SIMPLE SUMMARY: Poor-risk subgroups of pediatric germ cell tumors may have poor responses to conventional first-line chemotherapy. This review examines the current clinical perspectives of high-dose chemotherapy combined with autologous stem cell transplantation in children with relapse or refractory extracranial germ cell tumors and assesses the feasibility of applying autologous stem cell transplantation in high-risk patients with germ cell tumors. ABSTRACT: Pediatric extracranial germ cell tumors (GCTs) are rare, accounting for approximately 3.5% of childhood cancers. Since the introduction of platinum-based chemotherapy, the survival rate of patients has improved to more than 80%. However, poor-risk subtypes of pediatric extracranial GCTs do not respond well to chemotherapy, leading to refractory or relapsed (R/R) diseases. For example, long-term survival rates of mediastinal GCTs or choriocarcinoma are less than 50%. According to reports in recent years for adult patients with R/R GCTs, the use of high-dose chemotherapy (HDCT) combined with autologous stem cell transplantation (ASCT) has clinical advantages; however, HDCT combined with ASCT has rarely been reported in pediatric GCTs. The R/R and poor-risk groups of pediatric GCTs could benefit from HDCT and ASCT.