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Reduced-intensity preparative regimen and allogeneic stem cell transplantation for advanced solid tumors
Didier Blaise1, Jacques Olivier Bay, Catherine Faucher
1UTTC, Institut Paoli-Calmettes, 232 Bd Ste Marguerite, 13273 Marseille Cedex 09, France. uttc@marseille.fnclcc.fr
Blood
|August 30, 2003
Summary
Reduced-intensity conditioning allogeneic stem cell transplantation (RIC ASCT) shows promise for refractory metastatic solid tumors. Objective responses and improved survival were observed, particularly in patients without progressive disease at transplant.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Refractory metastatic solid tumors (STs) present limited treatment options.
- Allogeneic stem cell transplantation (ASCT) is explored for advanced STs.
- Reduced-intensity conditioning (RIC) regimens aim to improve ASCT safety.
Purpose of the Study:
- To evaluate the efficacy and safety of RIC ASCT in patients with refractory metastatic STs.
- To assess engraftment, transplant-related mortality (TRM), disease response, and overall survival (OS).
Main Methods:
- Prospective multicenter study involving 57 patients with refractory metastatic STs.
- RIC ASCT regimen included fludarabine, antithymocyte globulin (ATG), and busulfan.
- Analysis focused on engraftment, TRM, objective responses (ORs), and OS.
Main Results:
- Rapid engraftment and low TRM (9%) were observed.
- Cumulative incidence of ORs was 14%, significantly higher in patients without progressive disease (PD) at ASCT (44% vs. 0%).
- Achievement of OR and absence of PD at ASCT were associated with improved OS.
Conclusions:
- RIC ASCT can induce objective responses in refractory metastatic STs with acceptable TRM.
- Patient disease status at ASCT is a critical factor for outcomes.
- Further research is warranted for patients with less advanced STs.