title: Nonmyeloablative allogeneic stem cell transplantation for patients with unresectable pancreatic cancer.
abstract: OBJECTIVE
  To clarify whether nonmyeloablative allogeneic stem cell transplantation (NST) can produce the graft versus tumor (GVT) effect in patients with pancreatic cancer.
  
  
  METHODS
  A pilot trial of NST was conducted in 5 patients with unresectable pancreatic cancer. Preparative conditioning consisted of administration of 60 mg/kg cyclophosphamide on days 6 and 7 before transplantation, followed by 25 mg fludarabine per square meter of body surface on each of the last 5 days prior to transplantation. Cyclosporine was started 4 days before transplantation. Peripheral blood stem cells from the patients' HLA-identical siblings were transfused into the patients.
  
  
  RESULTS
  Complete donor T-cell chimerism in peripheral blood was obtained in 4 patients on day 15 after transplantation. NST resulted in tumor reduction in 2 patients as determined by CT, decreasing levels of tumor markers in 2 patients, pain relief in 2 patients, and a decrease in pleural fluid in 1 patient. Two patients developed acute graft versus host disease (GVHD) of grade II or III and 2 had chronic GVHD involving skin and/or liver. Administration of immunosuppressive drugs for the treatment of GVHD resulted in the elevation of tumor marker levels.
  
  
  CONCLUSIONS
  These findings are the first to suggest that NST induces a GVT effect on pancreatic cancer.
authors.affiliation: Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. t-toshio@po.kyoundo.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Omuro
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsumoto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hiruma
authors.forename: Koji
authors.initials: K
authors.lastname: Tsuruta
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000378:metabolism; D005260:Female; D020350:Graft vs Tumor Effect; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects; D033581:Stem Cell Transplantation; D014057:Tomography, X-Ray Computed; D018183:Transplantation Chimera; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D018395:CA-19-9 Antigen