Abstract
Pancreatic cancer is a frequent cause of cancer-related mortality and has an extremely poor prognosis. To evaluate the efficacy of allogeneic hematopoietic SCT with reduced-intensity conditioning (RICT) against pancreatic cancer, we analyzed the clinical data of 22 patients. After a fludarabine-based conditioning regimen followed by the infusion of PBSCs, all but two achieved engraftment. Complete, partial and minor response was observed in 1, 2 and 2 patients, respectively, with an overall response rate of 23%. Median survival was only 139 days and the major cause of death was tumor progression. Poor performance status before RICT and a lower number of infused CD34-positive cells were associated with shorter survival after RICT. Patients who developed chronic GVHD tended to survive longer than those who did not. These findings support the investigation of a novel treatment strategy to enhance the immunological effect against pancreatic cancer.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Champlin R, Khouri I, Shimoni A, Gajewski J, Kornblau S, Molldrem J et al. Harnessing graft-versus-malignancy: non-myeloablative preparative regimens for allogeneic haematopoietic transplantation, an evolving strategy for adoptive immunotherapy. Br J Haematol 2000; 111: 18–29.
Mohty M, de Lavallade H, Ladaique P, Faucher C, Vey N, Coso D et al. The role of reduced intensity conditioning allogeneic stem cell transplantation in patients with acute myeloid leukemia: a donor vs no donor comparison. Leukemia 2005; 19: 916–920.
Bregni M, Ueno NT, Childs R . The second international meeting on allogeneic transplantation in solid tumors. Bone Marrow Transplant 2006; 38: 527–537.
Ueno NT, Cheng YC, Rondon G, Tannir NM, Gajewski JL, Couriel DR et al. Rapid induction of complete donor chimerism by the use of a reduced-intensity conditioning regimen composed of fludarabine and melphalan in allogeneic stem cell transplantation for metastatic solid tumors. Blood 2003; 102: 3829–3836.
Bregni M, Dodero A, Peccatori J, Pescarollo A, Bernardi M, Sassi I et al. Nonmyeloablative conditioning followed by hematopoietic cell allografting and donor lymphocyte infusions for patients with metastatic renal and breast cancer. Blood 2002; 99: 4234–4236.
Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S et al. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 2000; 343: 750–758.
Burris III HA, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 1997; 15: 2403–2413.
Herrmann R, Bodoky G, Ruhstaller T, Glimelius B, Bajetta E, Schuller J et al. Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group. J Clin Oncol 2007; 25: 2212–2217.
Berlin JD, Catalano P, Thomas JP, Kugler JW, Haller DG, Benson III AB . Phase III study of gemcitabine in combination with fluorouracil versus gemcitabine alone in patients with advanced pancreatic carcinoma: Eastern Cooperative Oncology Group Trial E2297. J Clin Oncol 2002; 20: 3270–3275.
Heinemann V, Quietzsch D, Gieseler F, Gonnermann M, Schonekas H, Rost A et al. Randomized phase III trial of gemcitabine plus cisplatin compared with gemcitabine alone in advanced pancreatic cancer. J Clin Oncol 2006; 24: 3946–3952.
Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 2007; 25: 1960–1966.
Kaufman HL, Di Vito Jr J, Horig H . Immunotherapy for pancreatic cancer: current concepts. Hematol Oncol Clin North Am 2002; 16: 159–197, viii.
Omuro Y, Matsumoto G, Sasaki T, Tanaka Y, Maeda Y, Sakamaki H et al. Regression of an unresectable pancreatic tumor following nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. Bone Marrow Transplant 2003; 31: 943–945.
Takahashi T, Omuro Y, Matsumoto G, Sakamaki H, Maeda Y, Hiruma K et al. Nonmyeloablative allogeneic stem cell transplantation for patients with unresectable pancreatic cancer. Pancreas 2004; 28: e65–e69.
Kanda Y, Komatsu Y, Akahane M, Kojima S, Asano-Mori Y, Tada M et al. Graft-versus-tumor effect against advanced pancreatic cancer after allogeneic reduced-intensity stem cell transplantation. Transplantation 2005; 79: 821–827.
Thiede C, Florek M, Bornhauser M, Ritter M, Mohr B, Brendel C et al. Rapid quantification of mixed chimerism using multiplex amplification of short tandem repeat markers and fluorescence detection. Bone Marrow Transplant 1999; 23: 1055–1060.
Heimfeld S . HLA-identical stem cell transplantation: is there an optimal CD34 cell dose? Bone Marrow Transplant 2003; 31: 839–845.
Kim C, Matsumura M, Saijo K, Ohno T . In vitro induction of HLA-A2402-restricted and carcinoembryonic-antigen-specific cytotoxic T lymphocytes on fixed autologous peripheral blood cells. Cancer Immunol Immunother 1998; 47: 90–96.
Trede M, Schwall G, Saeger HD . Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg 1990; 211: 447–458.
Geer RJ, Brennan MF . Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 1993; 165: 68–72; discussion 72–63.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kanda, Y., Omuro, Y., Baba, E. et al. Allo-SCT using reduced-intensity conditioning against advanced pancreatic cancer: a Japanese survey. Bone Marrow Transplant 42, 99–103 (2008). https://doi.org/10.1038/bmt.2008.94
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/bmt.2008.94
Keywords
This article is cited by
-
Allogene Stammzelltransplantation bei pädiatrischen soliden Tumoren
Der Onkologe (2011)