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Antitumor effect of allogeneic hematopoietic SCT in metastatic medulloblastoma

Bone Marrow Transplantation volume 42, pages 131–133 (2008)Cite this article

Clinical studies of non-myeloablative allogeneic hematopoietic SCT (NST) have demonstrated that donor lymphocytes transferred with the graft may produce a clinically meaningful antitumor effect (graft-versus tumor) in recipients with renal cell cancer or other solid tumors refractory to conventional treatments.1, 2 Few data are currently available in this field in patients with medulloblastoma. Matsuda et al.3 reported one child who obtained a short-lasting PR following allogeneic hematopoietic SCT for relapsed medulloblastoma. Lundberg et al.4 reported one patient who achieved CR lasting more than 2 years following allogeneic hematopoietic SCT for recurrent metastatic medulloblastoma. However, a clear graft-versus tumor effect cannot be ruled out in these patients as they received myeloablative high doses of chemotherapy as the conditioning regimen, which might per se be responsible for tumor response. In this article, we report a durable complete tumor response following NST in a person with metastatic medulloblastoma.

In March 2003, the patient received a pre transplant conditioning regimen consisting of IV thiotepa (300 mg/m2) on day −5, CY (30 mg/kg daily) and fludarabine (30 mg/m2 daily) on days −4 and −3. On day 0, 6.62 × 106 filgrastim mobilized CD34+ cells and 4.4 × 108 CD3+ cells/kg recipient, collected from the 25-year-old HLA identical brother, were transplanted into the patient.7 Immunosuppression for GVHD prophylaxis consisted of CYA and short-course MTX. Antimicrobial therapy followed institutional protocols consisting of itraconazole for antifungal prophylaxis, acyclovir for antiviral prophylaxis and levofloxacin for antibacterial prophylaxis. The degree of donor–recipient chimerism in both myeloid and T-cell lineages was assessed by PCR assay of minisatellite regions.

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Acknowledgements

This study was partly supported by grants from Oncologia Ca' Granda Onlus (OCGO) Fondazione, Associazione Italiana per la Ricerca sul Cancro (AIRC) and A.V.I.S. Monsummano Terme Onlus ‘Per Elisa Contro il Medulloblastoma.’

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Authors and Affiliations

  1. S. C. Divisione Oncologia Falck and S. C. Divisione Anatomia Patologica, Ospedale Niguarda Ca' Granda, Milano, Italy

    S Secondino, P Pedrazzoli, I Schiavetto, V Basilico, E Bramerio, M Gambacorta & S Siena

  2. S. C. Divisione Pediatria, Istituto Nazionale Tumori, Milan, Italy

    M Massimino

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  1. S Secondino
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Correspondence to S Secondino.

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Secondino, S., Pedrazzoli, P., Schiavetto, I. et al. Antitumor effect of allogeneic hematopoietic SCT in metastatic medulloblastoma. Bone Marrow Transplant 42, 131–133 (2008). https://doi.org/10.1038/bmt.2008.86

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