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Allogeneic haematopoietic stem cell transplantation for metastatic renal carcinoma in Europe

Barkholt, L. ; Bregni, M. ; Remberger, M. ; Blaise, D. ; Peccatori, J. ; Massenkeil, G. ; Pedrazzoli, P. ; Zambelli, A. ; Bay, J. -O. and Francois, S. , et al. (2006) In Annals of Oncology 17(7). p.1134-1140
Abstract
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... (More)
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. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
reduced, allogeneic stem cell transplantation, intensity conditioning, renal cell carcinoma, antitumour effect
in
Annals of Oncology
volume
17
issue
7
pages
1134 - 1140
publisher
Oxford University Press
external identifiers
  • wos:000238905600016
  • scopus:33745588857
ISSN
1569-8041
DOI
10.1093/annonc/mdl086
language
English
LU publication?
yes
id
ec8a8fac-2a28-4d96-8451-45875076f3ef (old id 404247)
date added to LUP
2016-04-01 16:36:00
date last changed
2021-02-17 07:49:15
@article{ec8a8fac-2a28-4d96-8451-45875076f3ef,
  abstract     = {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 &lt; 0.001), DLI (HR 3.39, P &lt; 0.001), &lt; 3 metastatic sites (HR 2.61, P = 0.002) and a Karnofsky score &gt; 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 &gt; 70% can be considered for HSCT. Posttransplant DLI and limited chronic GVHD improved the patient survival.},
  author       = {Barkholt, L. and Bregni, M. and Remberger, M. and Blaise, D. and Peccatori, J. and Massenkeil, G. and Pedrazzoli, P. and Zambelli, A. and Bay, J. -O. and Francois, S. and Martino, R. and Bengala, C. and Brune, M. and Lenhoff, Stig and Porcellini, A. and Falda, M. and Siena, S. and Demirer, T. and Niederwieser, D. and Ringden, O.},
  issn         = {1569-8041},
  language     = {eng},
  number       = {7},
  pages        = {1134--1140},
  publisher    = {Oxford University Press},
  series       = {Annals of Oncology},
  title        = {Allogeneic haematopoietic stem cell transplantation for metastatic renal carcinoma in Europe},
  url          = {http://dx.doi.org/10.1093/annonc/mdl086},
  doi          = {10.1093/annonc/mdl086},
  volume       = {17},
  year         = {2006},
}