Annals of Oncology Advance Access published online on April 28, 2006
Annals of Oncology, doi:10.1093/annonc/mdl086
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1 Division of Clinical Immunology and Centre for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
* To whom correspondence should be addressed. Background: An allogeneic antitumour effect has been reported for various cancers. We evaluated the experience of allogeneic haematopoietic stem cell transplantation (HSCT) for renal cell carcinoma (RCC) in 124 patients from 21 European centres. Patients and methods: Reduced intensity conditioning and peripheral blood stem cells from an HLA-identical sibling (n = 106), a mismatched related (n = 5), or an unrelated (n = 13) donor were used. Immunosuppression was cyclosporine alone, or combined with methotrexate or mycophenolate mofetil. Donor lymphocyte infusions (DLI) were given to 42 patients. The median follow-up was 15 (range 3-41) months. Results: All but three patients engrafted. The cumulative incidence of moderate to severe, grades II-IV acute GVHD was 40% and for chronic GVHD it was 33%. Transplant-related mortality was 16% at one year. Complete (n = 4) or partial (n = 24) responses, median 150 (range 42-600) days post-transplant, were associated with time from diagnosis to HSCT, mismatched donor and acute GVHD II-IV. Factors associated with survival included chronic GVHD (hazards ratio, HR 4.12, P < 0.001), DLI (HR 3.39, P < 0.001), <3 metastatic sites (HR 2.61, P = 0.002) and a Karnofsky score >70 (HR 2.33, P = 0.03). Patients (n = 17) with chronic GVHD and given DLI had a 2-year survival of 70%. Conclusion: Patients with metastatic RCC, less than three metastatic locations and a Karnofsky score >70% can be considered for HSCT. Posttransplant DLI and limited chronic GVHD improved the patient survival.
Received January 11, 2006
Revised March 10, 2006
Accepted March 17, 2006
original article
Allogeneic haematopoietic stem cell transplantation for metastatic renal carcinoma in Europe
L. Barkholt 1 *,
M. Bregni 2,
M. Remberger 1,
D. Blaise 3,
J. Peccatori 2,
G. Massenkeil 4,
P. Pedrazzoli 5,
A. Zambelli 6,
J.-O. Bay 7,
S. Francois 8,
R. Martino 9,
C. Bengala 10,
M. Brune 11,
S. Lenhoff 12,
A. Porcellini 13,
M. Falda 14,
S. Siena 5,
T. Demirer 15,
D. Niederwieser 16,
O. Ringdén 1,
and
On behalf of the French ITAC group and the EBMT Solid Tumour Working Party
2 Istituto Scientifico H.S. Raffaele, Milan, Italy
3 Institut Paoli Calmettes, Marseille, France
4 Hospital Charité, Berlin, Germany
5 Ospedale Niguarda Ca' Granda, Milan, Italy
6 Fondazione S. Maugeri, Pavia, Italy
7 Centre Jean Perrin-CHU, Clermont Ferrand, France
8 CHRU Angers, France
9 Hospital Santa Creu I Sant Pau, Barcelona, Spain
10 St. Chiara University Hospital, Pisa, Italy
11 Sahlgrenska University Hospital, Gothenburg, Sweden
12 Lund University Hospital, Lund, Sweden
13 Departimento di Oncologia/Ematologia, Ospedale P.F. Calvi Noale, Italy
14 Azienda Ospedaliera S. Giovanni, Torino, Italy
15 Ankara University Medical School, Ankara, Turkey
16 University Hospital Leipzig, Leipzig, Germany
L. Barkholt, E-mail: lisbeth.barkholt{at}karolinska.se
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