Inclusion Criteria:

- Poor prognosis" according IGCCCG-criteria:

- Primary mediastinal tumor

- Gonadal/retroperitoneal germ cell tumor with visceral metastases except of lung

- Poor marker: AFP > 10.000 ng/ml or beta-HCG > 10.000 ng/ml (50.000 IU/l) andd LDH >10
x upper normal limit

- No previous chemotherapy

- Age > 18 years

- Performance-Status: WHO =< 2

- Written informed consent

- Ability to give informed consent

Exclusion Criteria:

- Hemolysis

- Hematological disease with insufficient erythropoiesis

- Patients without sufficient treatment of sideropenia, folate deficiency or vitamin
B12 deficiency

- Uncontrolled arterial hypertension

- Treatment with rh-Erythropoetin during trial

- Creatinin clearance < 50 ml/min

- Insufficient bone marrow function (WBC count < 3.000/ml or platelets < 100.000/µl)

- Other major symptomatic or uncontrolled illnesses not allowing to complete treatment
protocol with the exception of symptoms caused by the primary disease

- Second malignancy, except of completely resected basal cell carcinoma of the skin