title: Nonmyeloablative conditioning followed by hematopoietic cell allografting and donor lymphocyte infusions for patients with metastatic renal and breast cancer.
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.
authors: Bone Marrow Transplant Unit and Gene Therapy Program and the Division of Pathology, Istituto H San Raffaele, Milano, Italy. marco.bregni@hsr.it
authors: Marco
authors: M
authors: Bregni
authors: Anna
authors: A
authors: Dodero
authors: Jacopo
authors: J
authors: Peccatori
authors: Alessandra
authors: A
authors: Pescarollo
authors: Massimo
authors: M
authors: Bernardi
authors: Isabella
authors: I
authors: Sassi
authors: Claudia
authors: C
authors: Voena
authors: Alberto
authors: A
authors: Zaniboni
authors: Claudio
authors: C
authors: Bordignon
authors: Paolo
authors: P
authors: Corradini
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D002292:Carcinoma, Renal Cell / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009679:Nuclear Family; D017713:Platelet Transfusion; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000276:immunology* / Q000379:methods; D016896:Treatment Outcome