TY - JOUR
T1 - Nonmyeloablative allogeneic hematopoietic stem cell transplantation as immunotherapy for pancreatic cancer
AU - Abe, Yasunobu
AU - Ito, Tetsuhide
AU - Baba, Eishi
AU - Nagafuji, Koji
AU - Kawabe, Ken
AU - Choi, Ilseung
AU - Arita, Yoshiyuki
AU - Miyamoto, Toshihiro
AU - Teshima, Takanori
AU - Nakano, Shuji
AU - Harada, Mine
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2009/10
Y1 - 2009/10
N2 - OBJECTIVE: Advanced unresectable pancreatic cancer has an extremely poor prognosis despite intensive chemotherapy. As a new therapeutic modality, we investigated nonmyeloablative allogeneic hematopoietic stem cell transplantation from a related donor. METHODS: Five patients with chemotherapy-resistant pancreatic cancer received allogeneic peripheral blood stem cell transplantation after a conditioning regimen consisting of low-dose total body irradiation and fludarabine. The prophylaxis for graft-versus-host disease consisted of mycophenolate mofetil and cyclosporine. RESULTS: The median age of the 5 patients was 54 years, and the median duration from diagnosis to nonmyeloablative allogeneic hematopoietic stem cell transplantation was 10 months. Three of the 5 patients achieved complete donor chimerism of peripheral T cells, at a median time of day 42. Acute graft-versus-host disease developed in 3 patients: grade 2 in 2 patients and grade 1 in 1. Tumor reduction was observed in 2 patients: 1 patient showed disappearance of the pancreatic tumor, and the other patient showed approximately 20% reduction of the tumor. Marked elevation of tumor necrosis factor α was observed as the tumor regressed. CONCLUSIONS: Although advanced pancreatic cancer progresses rapidly, some graft-versus-tumor effects and pivotal role of tumor necrosis factor α were suggested. To obtain the durable response, patient selection and new strategies become important.
AB - OBJECTIVE: Advanced unresectable pancreatic cancer has an extremely poor prognosis despite intensive chemotherapy. As a new therapeutic modality, we investigated nonmyeloablative allogeneic hematopoietic stem cell transplantation from a related donor. METHODS: Five patients with chemotherapy-resistant pancreatic cancer received allogeneic peripheral blood stem cell transplantation after a conditioning regimen consisting of low-dose total body irradiation and fludarabine. The prophylaxis for graft-versus-host disease consisted of mycophenolate mofetil and cyclosporine. RESULTS: The median age of the 5 patients was 54 years, and the median duration from diagnosis to nonmyeloablative allogeneic hematopoietic stem cell transplantation was 10 months. Three of the 5 patients achieved complete donor chimerism of peripheral T cells, at a median time of day 42. Acute graft-versus-host disease developed in 3 patients: grade 2 in 2 patients and grade 1 in 1. Tumor reduction was observed in 2 patients: 1 patient showed disappearance of the pancreatic tumor, and the other patient showed approximately 20% reduction of the tumor. Marked elevation of tumor necrosis factor α was observed as the tumor regressed. CONCLUSIONS: Although advanced pancreatic cancer progresses rapidly, some graft-versus-tumor effects and pivotal role of tumor necrosis factor α were suggested. To obtain the durable response, patient selection and new strategies become important.
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U2 - 10.1097/MPA.0b013e3181b576ee
DO - 10.1097/MPA.0b013e3181b576ee
M3 - Article
C2 - 19696692
AN - SCOPUS:70349929284
VL - 38
SP - 815
EP - 819
JO - Pancreas
JF - Pancreas
SN - 0885-3177
IS - 7
ER -