Combination Chemotherapy Plus Peripheral Stem Cell Transplantation in Treating Patients With Germ Cell Tumors

Inclusion criteria:

* Male/Female with histologically confirmed GCT with review by the Department of Pathology at this center.
* Patients with advanced GCT, including patients with:

measurable or evaluable disease,

* patients with only elevated serum tumor markers (AFP and/or HCG), or
* patients with known residual disease after postchemotherapy surgery. Eligible patients must have established clinical resistance to cisplatin by their failure to achieve a durable CR to a cisplatin-based regimen.
* Prior treatment limited to ≤ 6 prior cycles (≤ four cycles preferred) of cisplatin. (GROUP A)
* Prior therapy \> 6 cycles of cisplatin. (GROUP B)
* Therapy must have been discontinued at least 3 weeks before entry onto protocol.
* Patients must have one or more unfavorable prognostic factors for achieving a CR to cisplatin-based salvage therapy. These are:
* Extragonadal primary site.
* Testis/ovarian primary site with the best response of an IR to first-line therapy, or a partial response with normal tumor markers of six months or less in duration.
* Prior treatment with ifosfamide-containing therapy
* General medical condition sufficient to allow for general anesthesia at the time of pheresis catheter placement.
* Patients must have negative serology for Human Immunodeficiency Virus.
* Laboratory criteria for protocol entry:

WBC ≥ 3000/ul Platelets 3 100,000/ul Cr Clearance \> 50 cc/min\*

\* (unless renal dysfunction is due to tumor obstructing the ureters in which case eligibility will be determined by the Principal Investigator).

* Age ≥ 15 years.
* Signed informed consent.

Exclusion Criteria:

* Presence of active infection
* Concurrent treatment with chemotherapy or
* Inability to comply with the treatment protocol or to undergo the specified follow-up tests for safety or effectiveness.
* Prior high-dose therapy with AuBMT.
* Patients must have recovered from recent surgery.