EVIDENCE FOR A GRAFT-VERSUS-TUMOR EFFECT IN A PATIENT TREATED WITH MARROW ABLATIVE CHEMOTHERAPY AND ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR BREAST-CANCER

Graft-versus-leukemia (GvL) has been shown to be an important immune-m ediated antitumor effect in hematologic malignancies. It is still unkn own whether such an immune-mediated antitumor effect has clinical impl ications in patients with solid tumors, A 32-year-old woman with infla mmatory breast cancer received a bone marrow transplant (BMT) from her HLA-identical sibling. During graft-versus-host disease (GvHD) cytoto xic T lymphocytes were grown and tested in a chromium-release assay ag ainst B and T lymphocytes of the patient and donor and against a panel of breast cancer cell lines, Resolution of liver metastases was obser ved simultaneously with clinical GvHD in the first weeks after transpl ant. In addition, mirror histocompatibility antigen (MiHA)-specific an d major histocompatibility complex (MHC) class I antigen-restricted cy totoxic T lymphocytes recognizing breast carcinoma target cells were i solated from the blood of the patient. Pretreatment of such target cel ls with tumor necrosis factor (TNF)-alpha but not with interferon (IFN )-alpha or IFN-gamma increased susceptibility of these cells to lysis by cytotoxic T lymphocytes. Clinical course and in vitro results sugge st that a graft-versus-tumor (GvT) effect might exist after allogeneic BMT for breast cancer, However, clinical experience on a larger scale would be required to determine the clinical efficacy of GvT effects i n patients with solid tumors. (C) 1996 by The American Society of Hema tology.