1. Graft-vs-tumor effect in patients with advanced nasopharyngeal cancer treated with nonmyeloablative allogeneic PBSC transplantation.
- Author
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Toh HC, Chia WK, Sun L, Thng CH, Soe Y, Phoon YP, Yap SP, Lim WT, Tai WM, Hee SW, Tan SH, Leong SS, and Tan EH
- Subjects
- Adult, Cyclophosphamide therapeutic use, Female, Humans, Lymphocyte Depletion, Male, Middle Aged, Nasopharyngeal Neoplasms pathology, Nasopharyngeal Neoplasms radiotherapy, Neoplasm Metastasis, Peripheral Blood Stem Cell Transplantation mortality, Survival Analysis, Transplantation Chimera, Transplantation, Homologous, Graft vs Tumor Effect, Nasopharyngeal Neoplasms therapy, Peripheral Blood Stem Cell Transplantation methods, Transplantation Conditioning methods
- Abstract
While nonmyeloablative peripheral blood stem cell transplantation (NST) has shown efficacy against several solid tumors, it is untested in nasopharyngeal cancer (NPC). In a phase II clinical trial, 21 patients with pretreated metastatic NPC underwent NST with sibling PBSC allografts, using CY conditioning, thymic irradiation and in vivo T-cell depletion with thymoglobulin. Stable lymphohematopoietic chimerism was achieved in most patients and prophylactic CYA was tapered at a median of day +30. Seven patients (33%) showed partial response and three (14%) achieved stable disease. Four patients were alive at 2 years and three showed prolonged disease control of 344, 525 and 550 days. With a median follow-up of 209 (4-1147) days, the median PFS was 100 days (95% confidence interval (CI), 66-128 days), and median OS was 209 days (95% CI, 128-236 days). Patients with chronic GVHD had better survival-median OS 426 days (95% CI, 194-NE days) vs 143 days (95% CI, 114-226 days) (P=0.010). Thus, NST may induce meaningful clinical responses in patients with advanced NPC.
- Published
- 2011
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