OBJECTIVES: To clarify whether nonmyeloablative allogeneic stem cell transplantation (NST) can produce the graft versus tumor (GVT) effect in patients with pancreatic cancer. METHODS: A pilot trial of NST was conducted in 5 patients with unresectable pancreatic cancer. Preparative conditioning consisted of administration of 60 mg/kg cyclophosphamide on days 6 and 7 before transplantation, followed by 25 mg fludarabine per square meter of body surface on each of the last 5 days prior to transplantation. Cyclosporine was started 4 days before transplantation. Peripheral blood stem cells from the patients' HLA-identical siblings were transfused into the patients. RESULTS: Complete donor T-cell chimerism in peripheral blood was obtained in 4 patients on day 15 after transplantation. NST resulted in tumor reduction in 2 patients as determined by CT, decreasing levels of tumor markers in 2 patients, pain relief in 2 patients, and a decrease in pleural fluid in 1 patient. Two patients developed acute graft versus host disease (GVHD) of grade II or III and 2 had chronic GVHD involving skin and/or liver. Administration of immunosuppressive drugs for the treatment of GVHD resulted in the elevation of tumor marker levels. CONCLUSION: These findings are the first to suggest that NST induces a GVT effect on pancreatic cancer.
OBJECTIVES: To clarify whether nonmyeloablative allogeneic stem cell transplantation (NST) can produce the graft versus tumor (GVT) effect in patients with pancreatic cancer. METHODS: A pilot trial of NST was conducted in 5 patients with unresectable pancreatic cancer. Preparative conditioning consisted of administration of 60 mg/kg cyclophosphamide on days 6 and 7 before transplantation, followed by 25 mg fludarabine per square meter of body surface on each of the last 5 days prior to transplantation. Cyclosporine was started 4 days before transplantation. Peripheral blood stem cells from the patients' HLA-identical siblings were transfused into the patients. RESULTS: Complete donor T-cell chimerism in peripheral blood was obtained in 4 patients on day 15 after transplantation. NST resulted in tumor reduction in 2 patients as determined by CT, decreasing levels of tumor markers in 2 patients, pain relief in 2 patients, and a decrease in pleural fluid in 1 patient. Two patients developed acute graft versus host disease (GVHD) of grade II or III and 2 had chronic GVHD involving skin and/or liver. Administration of immunosuppressive drugs for the treatment of GVHD resulted in the elevation of tumor marker levels. CONCLUSION: These findings are the first to suggest that NST induces a GVT effect on pancreatic cancer.
Authors: Andrea Boni; Pawel Muranski; Lydie Cassard; Claudia Wrzesinski; Chrystal M Paulos; Douglas C Palmer; Luca Gattinoni; Christian S Hinrichs; Chi-Chao Chan; Steven A Rosenberg; Nicholas P Restifo Journal: Blood Date: 2008-09-17 Impact factor: 22.113
Authors: Friedrich H Schmitz-Winnenthal; Thomas Schmidt; Monika Lehmann; Philipp Beckhove; Meinhard Kieser; Anthony D Ho; Peter Dreger; Markus W Büchler Journal: BMC Cancer Date: 2014-03-10 Impact factor: 4.430