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World J Transplant. Dec 24, 2016; 6(4): 675-681
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.675
Review of allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning in solid tumors excluding breast cancer
Nuri Karadurmus, Ugur Sahin, Bilgin Bahadir Basgoz, Fikret Arpaci, Taner Demirer
Nuri Karadurmus, Bilgin Bahadir Basgoz, Department of Medical Oncology, Gulhane Military Medical Academy, Etlik, 06018 Ankara, Turkey
Ugur Sahin, Taner Demirer, Department of Hematology, Ankara University Medical School, 06220 Ankara, Turkey
Fikret Arpaci, Department of Medical Oncology, Liv Hospital, 34034 Ankara, Turkey
Author contributions: Karadurmus N, Sahin U, Basgoz BB, Arpaci F and Demirer T contributed equally to this work; Arpaci F and Demirer T designed the concept; Karadurmus N, Sahin U, Basgoz BB, Arpaci F and Demirer T wrote the paper.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Taner Demirer, MD, FACP, Professor of Medicine and Hematology/Oncology, Department of Hematology, Ankara University Medical School, Cebeci Hospital, 06220 Ankara, Turkey. demirer@medicine.ankara.edu.tr
Telephone: +90-532-3251065 Fax: +90-312-4663717
Received: July 21, 2016
Peer-review started: July 26, 2016
First decision: October 21, 2016
Revised: November 1, 2016
Accepted: November 21, 2016
Article in press: November 23, 2016
Published online: December 24, 2016
Processing time: 145 Days and 22 Hours
Abstract

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 (e.g., renal cell cancer, colorectal cancer, etc.) 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.

Keywords: Renal cell carcinoma; Allogeneic hematopoietic stem cell transplantation; Colorectal cancer; Ovarian cancer; Sarcoma

Core tip: Some refractory metastatic solid tumors including renal, ovarian and even colon cancers may respond well to allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced intensity conditioning (RIC). Their lower toxicity profiles and lower non-relapse mortality rates constitute the advantages of RIC. The use of allo-HSCT with RIC or non-myeloablative regimens can be a feasible option among fragile patients, such as geriatric patients and patients with comorbidities. Future studies are needed for a clear-cut understanding of the mechanisms of graft-versus-leukemia and graft-versus-tumor effects of donor T-cells and their subsets in order to optimize the efficacy of such treatment modalities in patients with refractory solid tumors.