Successful Treatment of Kidney Caner with Allogeneic Blood Stem Cell Transplant

Metastatic Renal Cell Carcinoma: Successful Treatment with an Allogeneic Blood Stem Cell Transplant

Renal cell cancer can often be treated more effectively with biologic therapy than with chemotherapy. Biologic therapies directly facilitate or enhance a patient's immune system to fight the cancer. Biologic agents include interferons, interleukins, vaccines, and monoclonal antibodies. Another way to utilize the immune system to treat cancer is by transplanting a new immune system into a patient. This is referred to as an allogeneic stem cell transplant, and immune cells (the graft) are transplanted from one patient into another following the administration of high doses of chemotherapy or radiation which prepare the patient to receive the donor graft. This therapy is known to cure patients with leukemia, lymphoma, and other cancers.

Many doctors are trying to utilize the graft-versus-cancer effect associated with an allogeneic stem cell transplant to treat other types of cancer. These efforts have been hampered by the side effects of the treatment regimens administered to achieve engraftment and by the severity of the graft-versus-host reaction where the immune cells also attack the patients normal cells

Recently, doctors at the National Heart, Lung and Blood Institute have reported the successful treatment of a patient with metastatic renal cell carcinoma using a relatively non-toxic low-dose treatment regimen to facilitate engraftment. They administered the drugs cyclophosphamide and fludarabine followed by peripheral blood stem cells from a genetically similar sibling. Cyclosporine was administered after the peripheral blood stem cell infusion. Successful engraftment of sibling cells was achieved and complete disappearance of the patient's pulmonary metastatic disease occurred in 3 months and the patient remains in complete remission at 1 year from treatment. The patient suffered only mild graft-versus-host disease.

This single case report demonstrates the potential anti-tumor activity of the graft-versus-tumor effect of an allogeneic blood stem cell graft. These doctors and others are treating patients with many cancers in a similar fashion to determine effects of blood stem cell transplantation in patients with other incurable cancers such as advanced leukemias, lymphoma, multiple myeloma, melanoma, sarcomas, and lung cancer. ( Journal of Clinical Oncology, Vol 17, pp 2044-2049, 1999)

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