[Mark11]

Graft versus tumor effect in autologous transplants?

by Mark11 on Wed Sep 21, 2016 11:24 am

I just came across this paper. The author attempts to make a case that autolo­gous stem cell trans­plants can have a graft versus tumor effect as is seen in allogeneic (donor) stem cell trans­plants:

"In contrast to allogeneic hematopoietic stem cell transplantation, the current dogma is not an evidence of graft-versus-tumor effect in autologous hematopoietic stem cell trans­plan­tation; thus, it is assumed that autologous hemato­poietic stem cell trans­plan­ta­tion only relies on the high-dose chemotherapy to improve clinical outcomes. However, recent studies argue in favor of the existence of an autologous graft-versus-tumor with­out the detrimental complications of graft-versus-host disease due to the nonspecific immune response from the infused donor allo­reactive immune effector cells in allo­geneic hematopoietic stem cell transplantation. Herein, this paper reviews the clinical evi­dence of an autolo­gous graft-versus-tumor effect based on the auto­graft collected and infused host immune effector cells and host immunity recovery after autologous hemato­poietic stem cell trans­planta­tion affect­ing clinical out­comes in cancer patients."

Reference:

Porrata, Luis F, "Autologous Graft-versus-Tumor Effect: Reality or Fiction?", Advances in Hematology, August 2016 (full text of article)

A lot of the evidence is taken from B-cell non-Hodgkin's lymphoma, but there is some mention of myeloma studies. The author gets into things like this:

"To further validate the prognostic ability of the absolute lymphocyte count at day 15 after autologous hematopoietic stem cell transplantation to predict clinical outcomes, we conducted a prospective study. Our prospective study revealed a 5-year overall survival rates of 80% versus 37% and 5-year progression-free survival rates of 63% versus 13% for lymphoma patients with an absolute lymphocyte count equal to or greater than 500 cells/µL compared with less than 500 cells/µL at day 15 after autologous hematopoietic stem cell transplantation, respectively [6] (see Table 1)."

Probably not surprising a paper like this would come out since immunotherapy is "all the rage" in oncology currently.