Allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen for treatment of metastatic renal cell carcinoma: single institution experience with a minimum 1-year follow-up

• Published in: Experimental hematology 2004-07, Vol.32 (7), p.599-606
• Main Authors: Nakagawa, Tohru, Kami, Masahiro, Hori, Akiko, Kim, Sung-Won, Murashige, Naoko, Hamaki, Tamae, Kishi, Yukiko, Fujimoto, Hiroyuki, Matsuoka, Naoki, Okajima, Eijiro, Komiyama, Motokiyo, Tobisu, Ken-ichi, Wakayama, Toshio, Uike, Naokuni, Tajima, Kinuko, Makimoto, Atsushi, Mori, Shinichiro, Tanosaki, Ryuji, Takaue, Yoichi, Kakizoe, Tadao
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - therapy; Chronic Disease; Female; Follow-Up Studies; Graft vs Host Disease - epidemiology; Histocompatibility Testing; Humans; Kidney Neoplasms - pathology; Kidney Neoplasms - therapy; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Staging; Nephrectomy; Patient Selection; Retrospective Studies; Stem Cell Transplantation - adverse effects; Stem Cell Transplantation - methods; Stem Cell Transplantation - mortality; Survival Analysis; Time Factors; Transplantation Conditioning - methods; Transplantation, Homologous - adverse effects; Transplantation, Homologous - immunology; Transplantation, Homologous - methods; Transplantation, Homologous - mortality; Treatment Outcome
• ISSN: 0301-472X; 1873-2399
• DOI: 10.1016/j.exphem.2004.04.006

The aim of this study was to evaluate the safety and efficacy of allogeneic hematopoietic stem cell transplantation with a reduced-intensity conditioning regimen (RIST) for interferon-α–refractory metastatic renal cell carcinoma (RCC). Of 26 patients referred to the National Cancer Center Hospital for possible RIST between June 2000 and April 2002, an HLA-identical relative was identified for 12 patients. Nine patients underwent RIST. The conditioning regimen consisted of fludarabine 180 mg/m 2 or cladribine 0.66 mg/kg, plus busulfan 8 mg/kg and rabbit antithymocyte globulin 5 mg/kg. Graft-vs-host disease (GVHD) prophylaxis was cyclosporine alone. All patients achieved engraftment without grade III to IV nonhematologic regimen-related toxicity. All patients achieved complete donor-type chimerism without donor lymphocyte infusion by day 60. Four patients developed acute GVHD, and four developed chronic GVHD. One patient (11%) achieved partial response. As of July 2003, six patients were alive at median follow-up of 681 days. The actuarial overall survival rate was 89% at 1 year and 74% at 2 years. The overall survival rate tended to be higher in the 12 patients with a matched donor than in the other 14 patients without a matched donor ( p = 0.088). Our RIST procedure is feasible without severe toxicity. The efficacy of RIST for RCC should be confirmed in phase II/III clinical trials.