title: Long-Term Follow-Up of Allogeneic Hematopoietic Stem Cell Transplantation for Solid Cancer.
abstract: We wanted to determine whether allogeneic hematopoietic stem cell transplantation (HSCT) may result in long-term survival in patients with solid cancer. HSCT was performed in 61 patients with solid cancer: metastatic renal carcinoma (n = 22), cholangiocarcinoma (n = 17), colon carcinoma (n = 15), prostate cancer (n = 3), pancreatic adenocarcinoma (n = 3), or breast cancer (n = 1). Liver transplantation was performed for tumor debulking in 18 patients. Median age was 56 years (range, 28 to 77). Donors were either HLA-identical siblings (n = 29) or unrelated (n = 32). Conditioning was nonmyeloablative (n = 23), reduced (n = 36), or myeloablative (n = 2). Graft failure occurred in 13 patients (21%). The cumulative incidence of acute graft-versus-host disease (GVHD) of grades II to IV was 47%, and that of chronic GVHD was 32%. Treatment-related mortality was 21%. At 5 years cancer-related mortality was 63%. Currently, 6 patients are alive, 2 with renal cell carcinoma, 1 with cholangiocarcinoma, and 3 with pancreatic carcinoma. Eight-year survival was 12%. Risk factors for mortality were nonmyeloablative conditioning (HR, 2.95; P < .001), absence of chronic GVHD (HR, 3.57; P < .001), acute GVHD of grades II to IV (HR, 2.90; P = .002), and HLA-identical transplant (HR, 5.00; P = .03). With none of these risk factors, survival at 6 years was 50% (n = 6). Long-term survival can be achieved in some patients with solid cancer after HSCT.
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden; Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Brigitta
authors.initials: B
authors.lastname: Omazic
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Remberger
authors.affiliation: Division of Therapeutic Immunology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Barkholt
authors.affiliation: Department of Transplantation Surgery, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Söderdahl
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Potácová
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Wersäll
authors.affiliation: Department of Transplantation Surgery, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Bo-Göran
authors.initials: BG
authors.lastname: Ericzon
authors.affiliation: Center for Allogeneic Stem Cell Transplantation, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden; Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Mattsson
authors.affiliation: Division of Therapeutic Immunology, Karolinska Institutet and Karolinska University Hospital, Huddinge, Sweden. Electronic address: Olle.Ringden@ki.se.
authors.forename: Olle
authors.initials: O
authors.lastname: Ringdén
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D001943:Breast Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003110:Colonic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007680:Kidney Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D019653:Myeloablative Agonists; D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine
keywords: Allogeneic hematopoietic stem cell transplantation; Cholangiocarcinoma; Colon carcinoma; Pancreatic adenocarcinoma; Renal carcinoma