title: Allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen for treatment of metastatic renal cell carcinoma: single institution experience with a minimum 1-year follow-up.
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety and efficacy of allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen (RIST) for interferon-alpha-refractory metastatic renal cell carcinoma (RCC).
  
  
  METHODS
  Of 26 patients referred to the National Cancer Center Hospital for possible RIST between June 2000 and April 2002, an HLA-identical relative was identified for 12 patients. Nine patients underwent RIST. The conditioning regimen consisted of fludarabine 180 mg/m2 or cladribine 0.66 mg/kg, plus busulfan 8 mg/kg and rabbit antithymocyte globulin 5 mg/kg. Graft-vs-host disease (GVHD) prophylaxis was cyclosporine alone.
  
  
  RESULTS
  All patients achieved engraftment without grade III to IV nonhematologic regimen-related toxicity. All patients achieved complete donor-type chimerism without donor lymphocyte infusion by day 60. Four patients developed acute GVHD, and four developed chronic GVHD. One patient (11%) achieved partial response. As of July 2003, six patients were alive at median follow-up of 681 days. The actuarial overall survival rate was 89% at 1 year and 74% at 2 years. The overall survival rate tended to be higher in the 12 patients with a matched donor than in the other 14 patients without a matched donor (p = 0.088).
  
  
  CONCLUSIONS
  Our RIST procedure is feasible without severe toxicity. The efficacy of RIST for RCC should be confirmed in phase II/III clinical trials.
authors.affiliation: Urology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kami
authors.forename: Akiko
authors.initials: A
authors.lastname: Hori
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Naoko
authors.initials: N
authors.lastname: Murashige
authors.forename: Tamae
authors.initials: T
authors.lastname: Hamaki
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsuoka
authors.forename: Eijiro
authors.initials: E
authors.lastname: Okajima
authors.forename: Motokiyo
authors.initials: M
authors.lastname: Komiyama
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Tobisu
authors.forename: Toshio
authors.initials: T
authors.lastname: Wakayama
authors.forename: Naokuni
authors.initials: N
authors.lastname: Uike
authors.forename: Kinuko
authors.initials: K
authors.lastname: Tajima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Makimoto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Mori
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
authors.forename: Tadao
authors.initials: T
authors.lastname: Kakizoe
mesh_terms: D000208:Acute Disease; D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology; D006650:Histocompatibility Testing; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009392:Nephrectomy; D018579:Patient Selection; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000276:immunology / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome