Nonmyeloablative conditioning followed by hematopoietic cell allografting and donor lymphocyte infusions for patients with metastatic renal and breast cancer

• Published in: Blood Vol. 99; no. 11; pp. 4234 - 4236
• Main Authors: Bregni, Marco, Dodero, Anna, Peccatori, Jacopo, Pescarollo, Alessandra, Bernardi, Massimo, Sassi, Isabella, Voena, Claudia, Zaniboni, Alberto, Bordignon, Claudio, Corradini, Paolo
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.06.2002; The Americain Society of Hematology
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Carcinoma, Renal Cell - therapy; Female; Hematopoietic Stem Cell Transplantation; Humans; Kidney Neoplasms - pathology; Kidney Neoplasms - therapy; Lymphocyte Transfusion; Male; Medical sciences; Middle Aged; Neoplasm Metastasis; Nuclear Family; Platelet Transfusion; Tissue Donors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous - immunology; Transplantation, Homologous - methods; Treatment Outcome; Kidney disease; Antineoplastic agent; Human; Urinary system disease; Prognosis; Transfusion; Graft versus tumor reaction; Stem cell; Hematopoietic cell; Homograft; Metastasis; Malignant tumor; Non myeloablative treatment; Kidney; Mammary gland diseases; Treatment; Donor; Immunotherapy; Graft; Conditioning; Mammary gland; Lymphocyte
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V99.11.4234

The feasibility and toxicity of allogeneic stem cell transplantation after nonmyeloablative conditioning including thiotepa, fludarabine, and cyclophosphamide have been investigated in 6 patients with breast cancer and 7 patients with renal cell cancer. The program included the use of escalating doses of donor lymphocyte infusions (DLI) and/or interferon alpha (IFNα) for patients showing no tumor response and no graft-versus-host disease (GVHD). Patients were at high risk of transplant-related mortality (TRM) because of age, advanced stage, and previous treatments. We observed a partial remission in 4 renal cancer and in 2 breast cancer patients (one at the molecular level in the bone marrow), occurring after cyclosporine withdrawal or after DLI and/or IFNα. All the responses were accompanied by the occurrence of acute GVHD. We conclude that reduced-intensity allogeneic stem cell transplantation is a feasible procedure in renal and breast cancer, and that the exploitation of graft-versus-tumor effect after DLI is a promising finding.