Karadurmus Nuri, Sahin Ugur, Basgoz Bilgin Bahadir, Arpaci Fikret, Demirer Taner
Nuri Karadurmus, Bilgin Bahadir Basgoz, Department of Medical Oncology, Gulhane Military Medical Academy, Etlik, 06018 Ankara, Turkey.
World J Transplant. 2016 Dec 24;6(4):675-681. doi: 10.5500/wjt.v6.i4.675.
Solid tumors in adults constitute a heterogeneous group of malignancy originating from various organ systems. Solid tumors are not completely curable by chemotherapy, even though some subgroups are very chemo-sensitive. Recently, oncologists have focused on the use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced intensity conditioning (RIC) for the treatment of some refractory solid tumors. After the demonstration of allogeneic graft-versus-leukemia effect in patients with hematological malignancies who received allo-HSCT, investigators evaluated this effect in patients with refractory metastatic solid tumors. According to data from experimental animal models and preliminary clinical trials, a graft-versus-tumor (GvT) effect may also be observed in the treatment of some solid tumors (., renal cell cancer, colorectal cancer, .) after allo-HSCT with RIC. The use of RIC regimens offers an opportunity of achieving full-donor engraftment with GvT effect, as well as, a reduced transplant-related mortality. Current literature suggests that allo-HSCT with RIC might become a choice for elderly and medically fragile patients with refractory metastatic solid tumors.
成人实体瘤是一组起源于各种器官系统的异质性恶性肿瘤。实体瘤即使某些亚组对化疗非常敏感,也不能通过化疗完全治愈。最近,肿瘤学家将注意力集中在采用减低剂量预处理(RIC)的异基因造血干细胞移植(allo-HSCT)来治疗一些难治性实体瘤上。在接受allo-HSCT的血液系统恶性肿瘤患者中证实了异基因移植物抗白血病效应后,研究人员在难治性转移性实体瘤患者中评估了这种效应。根据实验动物模型和初步临床试验的数据,在采用RIC的allo-HSCT治疗某些实体瘤(如肾细胞癌、结直肠癌等)后,也可能观察到移植物抗肿瘤(GvT)效应。使用RIC方案提供了实现完全供体植入并伴有GvT效应的机会,同时还降低了移植相关死亡率。目前的文献表明,采用RIC的allo-HSCT可能会成为老年和身体状况较差的难治性转移性实体瘤患者的一种选择。