Cardiovascular events in survivors of high-dose chemotherapy for germ cell tumors.

The objective was to investigate cardiovascular complications in long-term survivors treated by high-dose chemotherapy. We analyzed 13 previously successfully treated metastatic germ cell cancer patients. The patients ranged in age from 16 to 38 years (median: 27 years). Patients were treated by high-dose ifosfamide, carboplatin and etoposide (ICE) or high-dose etoposide, ifosfamide and cisplatin (VIP). In a minimal follow-up of 48 months, the incidence of cardiovascular events and the accumulated doses of platinum were analyzed from the total amounts of cisplatin and/or carboplatin. The calculated accumulated doses of platinum ranged from 487 to 4302 mg (median: 2297 mg). Cardiovascular events were observed in two patients who received cumulative doses of more than 3000 mg of platinum. Survivors of high-dose chemotherapy may have a risk of developing cardiovascular complications during the early phase of follow-up. In particular, patients who have received carboplatin-based high dose chemotherapy require careful observation.