[Immunotherapy with allogeneic haematopoietic stem cell transplantation: current status and perspectives]

Cancer represents a major problem of public health. New therapeutic approaches are needed to complete the present strategies. The use of immunotherapy for cancer treatment is a promising strategy. Allogeneic stem cell transplantation (allo-SCT) is the most widely used form of immunotherapy. The allogeneic immune effectors infused with the graft can recognize and eradicate the patients' tumoral cells.

The curative potential of allo-SCT is classically based on the cytoreduction of tumoral cells induced during the high dose chemo- and/or radiotherapy-based conditioning regimen and the immune control mediated by allogeneic immune effectors (graft versus tumor effect, GVT). Allo-SCT is currently under important mutations because of better understanding of the GVT mechanisms and the development of new treatment techniques: (a) allo-SCT of peripheral blood stem cells after mobilization with G-CSF; (b) donor lymphocyte infusion (DLI); and (c) development of reduced intensity conditioning regimens aiming to reduce the toxicity while favoring the immune component of the anti-tumoral effect.

In addition to its established efficacy in hematological malignancies, several arguments are in favor of the use of allo-SCT in neoplastic solid tumors. Promising results from advanced cancer patients were already obtained. The present experience shows clearly that the allo-SCT strategy should be developed and refined because of the potential benefit that can be expected in some patients' sub-groups.