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

Blood. 2002 Jun 1;99(11):4234-6. doi: 10.1182/blood.v99.11.4234.

Abstract

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 (IFNalpha) 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 IFNalpha. 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.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • 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
  • Middle Aged
  • Neoplasm Metastasis
  • Nuclear Family
  • Platelet Transfusion*
  • Tissue Donors
  • Transplantation, Homologous / immunology*
  • Transplantation, Homologous / methods
  • Treatment Outcome