title: Prognostic factors for survival in patients with advanced renal cell carcinoma undergoing nonmyeloablative allogeneic stem cell transplantation.
abstract: BACKGROUND
  The objective of this study was to identify prognostic factors for predicting survival in patients with advanced renal cell carcinoma (RCC) who had undergone an allogeneic stem cell transplantation after failure on immunotherapy.
  
  
  METHODS
  The authors studied 70 patients with advanced RCC who underwent allogeneic transplantation with a fludarabine-based, reduced-intensity regimen. Ten parameters were analyzed at the time of transplantation for their power to predict survival. Clinical features were examined first univariately; then, variables that were correlated significantly with survival in the univariate analysis were included in a multivariate Cox regression model.
  
  
  RESULTS
  Factors that were found to be associated significantly with limited survival were performance status, the number of metastatic sites, the presence of mediastinal metastasis, hemoglobin level, C-reactive protein (CRP) level, lactate dehydrogenase (LDH) level, and neutrophil counts. All these variables were included in a multivariate Cox regression model, and three were retained in the final model. Patients were classified according to the score estimated by the final Cox model in two groups (above or below the median value): The median survival was 3.5 months for patients who had a poor prognosis patients versus 23 months for patients who had a good prognosis.
  
  
  CONCLUSIONS
  The current findings suggested that three easily available parameters (performance status, CRP level, and LDH level) could be used to stratify patients with advanced RCC who are candidates for allografting and to assist clinicians in decision-making and selection of an appropriate treatment program.
authors.affiliation: Hematology-Bone Marrow Transplant Unit, Istituto Scientifico H. San Raffaele, Milano, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Peccatori
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Barkholt
authors.forename: Tanner
authors.initials: T
authors.lastname: Demirer
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Sormani
authors.forename: Paolo
authors.initials: P
authors.lastname: Bruzzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Alberto
authors.initials: A
authors.lastname: Zambelli
authors.forename: Gian Antonio
authors.initials: GA
authors.lastname: Da Prada
authors.forename: Paolo
authors.initials: P
authors.lastname: Pedrazzoli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Siena
authors.forename: Gero
authors.initials: G
authors.lastname: Massenkeil
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Martino
authors.forename: Stig
authors.initials: S
authors.lastname: Lenhoff
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosti
authors.forename: Olle
authors.initials: O
authors.lastname: Ringden
authors.forename: Marco
authors.initials: M
authors.lastname: Bregni
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D017567:Karnofsky Performance Status; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D011379:Prognosis; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous
chemical_list: D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase