Syngeneic Transplantation

The FHCRC and the EBMTR have reported long-term follow-up of patients receiving syngeneic transplants. Five of the nine evaluable patients treated at the FHCRC achieved a CR after transplant, three a PR, and one patient had no response. Of the five patients who achieved a CR, three relapsed and one died of myelodys-plastic syndromes; one patient remains in remission with a small monoclonal spike at 15 years after transplant. Two patients died of treatment-related complications early after transplant.30

The EBMTR has reported on 24 patients who received syngeneic transplant.31 Sixty-eight percent entered a CR. Three of 17 patients relapsed, and 2 died of transplant-related complications. The overall survival and progression-free survival are 73 months and 72 months, respectively. These data were compared with EBMTR results for autologous and allogeneic transplants. The relapse rate was lower after syngeneic than autologous transplant, but similar to that observed after allogeneic transplant. These results suggest that the higher relapse rate seen after autologous transplant compared to syngeneic transplant is related either to reinfusion of malignant cells in the autograft or to the presence of a GvM effect in the setting of syngeneic transplantation.

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