Dr. John Thompson, MD, is presently at the Seattle Cancer Care Alliance which combines the expertise of the U. of Washington and the Fred Hutchinson Cancer Center. He is part of the Fred Hutchinson transplant team and is a long term member of the Kidney Cancer Association's Medical Advisory Board.
Dr. Thompson discussed the theory behind the stem cell transplant. Compared to the more complete bone marrow transplant, the stem cell represents a "less is more" hypothesis. Less pre-conditioning sets the stage by allowing the patients' original dendritic cells to survive to present antigens.
He indicated there is a greater success rate with closely matched sibling donors.
The procedure was called an allograft. Allogeneic immunotherapy means the stem cell graft comes from a donor. It involves immuno-suppression, both pre and post-transplant to minimize rejection of the new immune system. The post-transplant suppression is gradually weaned and managed to control Graft Versus Host Disease, a common and potentially serious complication of allogeneic transplants where the, donor immune system attacks the patient's tissues. There are also infusions of donor lymphocytes after the initial procedure to boost the immune system.
For success in kidney cancer the chimerism (mixture of original immune system with the new donated system) must progress completely to all donor.