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Old 07-31-2005, 08:36 AM   #1
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Cancer News Article



Tandem Stem Cell Transplants Offer Promise in Metastatic Breast Cancer
High-dose chemotherapy (HDC) and autologous stem cell transplantation, followed by a mini allogeneic stem cell transplant, results in remission in some women with metastatic breast cancer, according to a study in The Lancet.

High-dose chemotherapy kills more cancer cells than moderate doses. However, HDC also results in more side effects, particularly to the blood-producing hematopoietic stem cells. Hematopoietic stem cells are immature blood cells produced in the bone marrow that mature into red blood cells (which carry oxygen to tissues), white blood cells (which fight infection), and platelets (which aid in blood clotting). An autologous stem cell transplant involves the collection of a patient’s own stem cells prior to treatment and re-infusion of the “harvested” stem cells after HDC to restore depleted blood cell levels. An allogeneic stem cell transplant refers to the use of a donor’s stem cells. A potential benefit of an allogeneic stem cell transplant is that the donor cells may recognize the cancer cells as foreign and mount an attack against them. Unfortunately, they may also recognize the patient as foreign and mount an attack against healthy tissues. This is called “graft versus host disease” (GVHD). The allogeneic stem cell transplant used in this study was a “mini” or “nonmyeloablative” transplant, which is associated with less GVHD.

Between September 1997 and April 2004, researchers in Italy treated 17 women with metastatic breast cancer with HDC and autologous stem cell transplantation followed by a mini allogeneic stem cell transplant. Three of the 17 women experienced a partial disappearance of their cancer after HDC and autologous stem cell transplantation and complete disappearance of their cancer after the mini allogeneic stem cell transplantation. All of these women developed GVHD before their cancer disappeared. These three women remain alive and in remission 3.6 to 5.9 years after their treatment.

This study suggests that HDC and autologous stem cell transplantation, followed by a mini allogeneic stem cell transplant, may benefit some women with metastatic breast cancer. The researchers believe that these findings “are highly exciting and could open new leads for the chemoimmunotherapy of breast cancer.”

Reference: Carella AM, Beltrami G, Corsetti MT et al. Reduced intensity conditioning for allograft after cytoreductive autograft in metastatic breast cancer. The Lancet. 2005;366:318-320.

Accompanying commentary: Childs R, Srinivasan R. High-dose chemotherapy and allogeneic immunotherapy. The Lancet. 2005;366:318-320.273-275.

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