Allogeneic hematopoietic cell transplantation for metastatic breast cancer

We reviewed 66 women with poor-risk metastatic breastcancer from 15 centers to describe the efficacy ofallogeneic hematopoietic cell transplantation (HCT).Median follow-up for survivors was 40 months (range,3–64). A total of 39 patients (59%) received myeloabla-tive and 27 (41%) reduced-intensity conditioning (RIC)regimens. More patients in the RIC group had poorpretransplant performance status (63 vs 26%, P¼0.002).RIC group developed less chronic GVHD (8 vs 36% at 1year, P¼0.003). Treatment-related mortality rates werelower with RIC (7 vs 29% at 100 days, P¼0.03). A totalof 9 of 33 patients (27%) who underwent immunemanipulation for persistent or progressive disease haddisease control, suggesting a graft-vs-tumor (GVT) effect.Progression-free survival (PFS) at 1 year was 23% withmyeloablative conditioning and 8% with RIC (P¼0.09).Women who developed acute GVHD after an RICregimen had lower risks of relapse or progression thanthose who didnot (relative risk, 3.05: P¼0.03),consistentwith a GVT effect, but this did not affect PFS. Thesefindings support the need for preclinical and clinicalstudies that facilitate targeted adoptive immunotherapyfor breast cancer to explore the benefit of a GVT effect inbreast cancer.Bone Marrow Transplantation (2008) 41, 537–545;doi:10.1038/sj.bmt.1705940;publishedonline17December2007Keywords: