학술논문
Autologous graft-versus-host disease induction in advanced breast cancer: role of peripheral blood progenitor cells.
Document Type
Journal Article
Author
Source
Subject
*BREAST cancer
*BLOOD cells
*BREAST tumor treatment
*THERAPEUTIC use of interferons
*IMMUNOSUPPRESSIVE agents
*ANTINEOPLASTIC agents
*BONE marrow transplantation
*BREAST tumors
*COMPARATIVE studies
*CYCLOSPORINE
*DOSE-effect relationship in pharmacology
*GRAFT versus host disease
*HEMATOPOIETIC stem cells
*HEMATOPOIETIC stem cell transplantation
*IMMUNITY
*KILLER cells
*LYMPHOCYTES
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*RESEARCH funding
*SURVIVAL analysis (Biometry)
*TRANSPLANTATION immunology
*EVALUATION research
*CYCLOPHOSPHAMIDE
*THIOTEPA
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Language
ISSN
0007-0920
Abstract
The purpose of the present study was to investigate the impact of the use of peripheral blood progenitor cells (PBPCs) on the induction of autologous graft-versus-host disease (GVHD) in patients with advanced breast cancer. 14 women with stage IIIB and 36 women with stage IV breast cancer received cyclosporine (CsA) 2.5 mg kg-1 i.v. daily, d 0-28, and interferon-gamma (IFNg) 0.025 mg/m2 s.c. qod, d7-28, following PBPC-T +/- bone marrow transplantation (BMT). Preceding high-dose chemotherapy consisted of cyclophosphamide 6 g/m2 and thiotepa 800 mg/m2. Histologically proven > or = grade II cutaneous GVHD was induced in18/50 (36%) of patients and was independent of the source of haematopoietic support. In vitro studies showed that post-transplant, 76% of patients had developed auto-cytotoxicity against their own pre-transplant PHA-lymphoblasts. A significant correlation between the occurrence of GVHD > or = grade II and cytolysis was observed in the NK cell-line K562 and the T47D breast cancer cell-line. With a median follow-up of 2(1/2) years, the overall survival (OS) is 58%, the disease-free survival (DFS) 26%, both independent of the development of GVHD and similar to what has been observed in other studies on high-dose chemotherapy in advanced breast cancer. It therefore remains unclear whether the induction of autologous GVHD with the occurrence of auto-cytotoxic lymphocytes can result in an anti-tumour effect in this group of patients. [ABSTRACT FROM AUTHOR]