Abstract
Pts with metastatic solid tumors, refractory to chemotherapy, present, a poor prognosis. Allogeneic BMT delivers the best disease control in leukemia. Thus we proposed this strategy to 12 pts (age: 37(21–45); M/F = 3/9) with refractory solid tumors (Breast: 3, Kidney: 3; Melanoma: 3; Ovarian: 2; Sarcoma: 1). All received an allo BMT from a identical sibling. The first 6 pts were prepared with Buscy200 regimen and a GVHD prophylaxis associating CSA and MTX. The 6 others received Busulfan (8 mg/kg) + Fludarabine + ATG (Mini) and CSA as GVHD prophylaxis. Only 3 pts received post graft GCSF. One patient (ovarian) died on day 5 from disease progression. All others had full hematological recovery. Among 9 studied pts, 5 had mixed donor chimerism (90% (90–99.7)) and 4 full DC. 4 pts presented grade 2 AGVHD. 3 pts received DLI prior day 100. Only 1 pt (refractory ovarian carcinoma) experienced an objective response: this was correlated with GVHD evolution : 20 mths after transplant, after a new progression, she is receiving DLI. 3 pts are alive at 8, 10 and 20 mths with measurable disease. 9 pts decreased at 3 mths (1-10) (progression: 8; TRM: 1 (Buscy regimen)). These data indicates that in this situation allo BMT is feasible notably using mini regimen. However the speed of disease evolution limits the possibility to obtain an allo effect inviting to treat these pts sooner. Based on these data, a multicenter trial is presently ongoing in France.
Published Version
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