Nonmyeloablative Allogenic Peripheral Blood Stem Cell Transplantation for Lung Metastases of Renal Cell Carcinoma

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  • Doki Noriko
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine
  • Matsushima Takafumi
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine
  • Saito Yasuyuki
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine
  • Yokohama Akihiko
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine
  • Tsukamoto Norifumi
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine
  • Karasawa Masamitsu
    Division of Blood Transfusion Service, Gunma University Hospital
  • Murakami Hirokazu
    Department of Health Science, Faculty of Medicine, Gunma University
  • Suzuki Kazuhiro
    Department of Urology, Gunma University Graduate School of Medicine
  • Nojima Yoshihisa
    Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine

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Other Title
  • 腎細胞癌の多発性肺転移症例に対する骨髄非破壊的同種末梢血幹細胞移植
  • 症例報告 腎細胞癌の多発性肺転移症例に対する骨髄非破壊的同種末梢血幹細胞移植
  • ショウレイ ホウコク ジンサイボウガン ノ タハツセイ ハイ テンイ ショウレイ ニ タイスル コツズイ ヒハカイテキ ドウシュ マッショウケツ カンサイボウ イショク

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Abstract

A 56-year-old male underwent a left nephrectomy in 1996. A histological examination resulted in a diagnosis of a clear-renal-cell carcinoma (T3, N1, M0). After undergoing a nephrectomy , he received subcutaneous interferon α for a year. In November 1998, a CT scan showed lung metastases. He received subcutaneous interferon α again. However follow-up CT scans showed progressive disease. In June 2000, the metastases additionally appeared in the right kidney and adrenal gland. As a result, he underwent a partial right kidney and adrenal gland resection. Coxal bone metastases appeared before stem cell transplantation. In March 2001 , he underwent nonmyeloablative allogenic peripheral blood stem cell transplantation (NST) from his HLA-identical sister due to multiple lung metastases. A chimerism analysis of his blood demonstrated 100% donor chimerism in the T-lymphoid lineages on day 28. Acute and chronic graft-versus-host-disease (GVHD) developed and could not be controlled. It was difficult to reduce the steroid dosage. Because we reduced the dosage, thereafter the GVHD developed again. The renal cell carcinoma progressed and on day 793 he died due to cardiac failure and pulmonary hemorrhaging. The effect of NST was a regression of the lung metastases. However, the metastases to the right kidney and coxal bone nevertheless progressed. Differences were observed in the graft-versus-tumor-effect (GVT) between the lung metastases and other metastatic organs.

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