Faculty Collaboration Database

Allogeneic hematopoietic cell transplantation for metastatic breast cancer. Bone Marrow Transplant 2008 Mar;41(6):537-45

Date

12/18/2007

Pubmed ID

18084340

DOI

10.1038/sj.bmt.1705940

Scopus ID

2-s2.0-41549095493 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

We reviewed 66 women with poor-risk metastatic breast cancer from 15 centers to describe the efficacy of allogeneic hematopoietic cell transplantation (HCT). Median follow-up for survivors was 40 months (range, 3-64). A total of 39 patients (59%) received myeloablative and 27 (41%) reduced-intensity conditioning (RIC) regimens. More patients in the RIC group had poor pretransplant performance status (63 vs 26%, P=0.002). RIC group developed less chronic GVHD (8 vs 36% at 1 year, P=0.003). Treatment-related mortality rates were lower with RIC (7 vs 29% at 100 days, P=0.03). A total of 9 of 33 patients (27%) who underwent immune manipulation for persistent or progressive disease had disease control, suggesting a graft-vs-tumor (GVT) effect. Progression-free survival (PFS) at 1 year was 23% with myeloablative conditioning and 8% with RIC (P=0.09). Women who developed acute GVHD after an RIC regimen had lower risks of relapse or progression than those who did not (relative risk, 3.05: P=0.03), consistent with a GVT effect, but this did not affect PFS. These findings support the need for preclinical and clinical studies that facilitate targeted adoptive immunotherapy for breast cancer to explore the benefit of a GVT effect in breast cancer.

Author List

Ueno NT, Rizzo JD, Demirer T, Cheng YC, Hegenbart U, Zhang MJ, Bregni M, Carella A, Blaise D, Bashey A, Bitran JD, Bolwell BJ, Elfenbein GJ, Fields KK, Freytes CO, Gale RP, Lazarus HM, Champlin RE, Stiff PJ, Niederwieser D

Authors

J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antineoplastic Agents
Breast Neoplasms
Combined Modality Therapy
Disease-Free Survival
Female
Graft vs Host Disease
Graft vs Tumor Effect
Hematopoietic Stem Cell Transplantation
Humans
Middle Aged
Myeloablative Agonists
Neoplasm Metastasis
Recurrence
Retrospective Studies
Survival Analysis
Transplantation, Homologous