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  • Original Article
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Allografting

Allogeneic hematopoietic cell transplantation for metastatic breast cancer

Abstract

We reviewed 66 women with poor-risk metastatic breast cancer from 15 centers to describe the efficacy of allogeneic hematopoietic cell transplantation (HCT). Median follow-up for survivors was 40 months (range, 3–64). A total of 39 patients (59%) received myeloablative and 27 (41%) reduced-intensity conditioning (RIC) regimens. More patients in the RIC group had poor pretransplant performance status (63 vs 26%, P=0.002). RIC group developed less chronic GVHD (8 vs 36% at 1 year, P=0.003). Treatment-related mortality rates were lower with RIC (7 vs 29% at 100 days, P=0.03). A total of 9 of 33 patients (27%) who underwent immune manipulation for persistent or progressive disease had disease control, suggesting a graft-vs-tumor (GVT) effect. Progression-free survival (PFS) at 1 year was 23% with myeloablative conditioning and 8% with RIC (P=0.09). Women who developed acute GVHD after an RIC regimen had lower risks of relapse or progression than those who did not (relative risk, 3.05: P=0.03), consistent with a GVT effect, but this did not affect PFS. These findings support the need for preclinical and clinical studies that facilitate targeted adoptive immunotherapy for breast cancer to explore the benefit of a GVT effect in breast cancer.

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Acknowledgements

Other authors include are Javier Garcia-Conde, Gabriela Rondón, Roger H Herzig, Charles F LeMaistre, Philip L McCarthy, Elizabeth C Reed, Shimon Slavin, Edward A Stadtmauer, Karen H Antman, Richard Childs and Mary M Horowitz.

This was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute; Office of Naval Research; Health Services Research Administration (DHHS); Programme Hospitalier de Recherche Clinique (PHRC2000, France); Deutsche Krebshilfe, Verbund Allogene Stammzelltransplantation und Immuntherapeutische Strategien; Associazione Italiana per la Ricerca sul Cancro, Italy; and grants from AABB, Abbott Laboratories; Aetna; AIG Medical Excess; American Red Cross; Amgen Inc.; Anonymous donation to the Medical College of Wisconsin; AnorMED Inc.; Astellas Pharma US Inc.; Berlex Laboratories Inc.; Biogen IDEC Inc.; Blue Cross and Blue Shield Association; BRT Laboratories Inc.; Celgene Corp.; Cell Therapeutics Inc.; CelMed Biosciences; Chugai Germany; Cubist Pharmaceuticals; Dynal Biotech, LLC; Edwards Lifesciences RMI; Endo Pharmaceuticals Inc.; Enzon Pharmaceuticals Inc.; Gambro BCT Inc.; Genzyme Corporation; GlaxoSmithKline Inc.; Histogenetics Inc.; Human Genome Sciences; Kirin Brewery Company; Ligand Pharmaceuticals Inc.; Medac GmbH Germany; Merck & Co.; Millennium Pharmaceuticals; Miller Pharmacal Group; Milliman USA Inc.; Miltenyi Biotec; National Center for Biotechnology Information; National Leukemia Research Association; National Marrow Donor Program; NeoRx Corporation; Novartis Pharmaceuticals Inc.; Novo Nordisk Pharmaceuticals; Ortho Biotech Inc.; Osiris Therapeutics Inc.; Pall Medical; PDL Bio Pharma Inc.; Pfizer Inc.; Pharmion Corp.; QOL Medical; Roche Laboratories; StemCyte Inc.; Stemco Biomedical; StemSoft Software Inc.; SuperGen Inc.; Sysmex; THERAKOS Inc.; University of Colorado Cord Blood Bank; Valeant Pharmaceuticals; ViaCell Inc.; ViraCor Laboratories; WB Saunders Mosby Churchill; and Wellpoint Inc.; and Zelos Therapeutics Inc.

We thank Christine Wogan and Sandy Sobotka for their excellent help in editing the manuscript.

The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense or any other agency of the US Government.

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Correspondence to J D Rizzo.

Appendix

Appendix

We also acknowledge the following institutions for contributing transplantation data for this study: Roswell Park Cancer Institute, Buffalo, NY, USA; University of Alabama, Birmingham, AL, USA; MD Anderson Cancer Center, Houston, TX, USA; Loyola University Medical Center, Maywood, IL, USA; Louisiana State University Medical Center, Shreveport, LA, USA; Roger Williams Medical Center, Providence, RI, USA; Richland Memorial Hospital. Columbia, SC, USA; University of California-San Diego, La Jolla, CA, USA; Memorial Medical Center, New Orleans, LA, USA; Blood and Marrow Group of Georgia, Atlanta, GA, USA; Hospital G U Gregorio Maranon, Madrid, Spain; Ruprecht-Karls-Universitaet, Heidelberg, Germany; University of Iowa Hospital and Clinics, Iowa City, IA, USA. Genoa, Italy; Marseille, France; Innsbruck, Austria; Leipzig, Germany; Milan, Italy.

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Ueno, N., Rizzo, J., Demirer, T. et al. Allogeneic hematopoietic cell transplantation for metastatic breast cancer. Bone Marrow Transplant 41, 537–545 (2008). https://doi.org/10.1038/sj.bmt.1705940

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