Reduced intensity conditioning for allograft after cytoreductive autograft in metastatic breast cancer

Angelo M. Carella, Germana Beltrami, Maria T. Corsetti, Sandro Nati, Pellegrino Musto, Potito Scalzulli, Roberta Gonella, Alberto Ballestrero, Franco Patrone

Research output: Contribution to journalArticle

Abstract

The benefits of allografting noted in some malignant diseases might be safely extended to metastatic breast cancer by a combination of cytoreduction with high-dose chemotherapy (HDT) and autologous stem-cell transplant (ASCT) with graft-versus-tumour effect mediated by transplanted donor immune cells with nonmyeloablative allografting (reduced intensity conditioning transplantation, RICT). 17 patients with heavily pretreated disease were given tandem transplants. 13 patients sustained donor engraftment. Three had partial remission after HDT and ASCT and complete remission after RICT; they achieved full chimerism and all developed graft-versus-host disease (GVHD) before regression of cancer. Another patient did not respond to HDT and ASCT but had partial remission after RICT, giving an overall response rate of 24%. Five patients had grade II or higher acute GVHD and five had extensive chronic GVHD. No non-relapse-related deaths occurred during the first 100 days. Five patients (29%) were alive 90-2160 days (median 1320) after RICT. This two-step approach is feasible in patients with metastatic breast cancer.

Original languageEnglish
Pages (from-to)318-320
Number of pages3
JournalLancet
Volume366
Issue number9482
DOIs
Publication statusPublished - Jul 23 2005

ASJC Scopus subject areas

  • Medicine(all)

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