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The Boyle Authorized Version The following notes were taken by PJ Boyle during the 2001 Kidney Cancer Association convention in San Francisco, CA, July 20-22. These notes are provided to allow non-attendees to get an overview of material presented at the conference, but they have not been approved by the speaker, the KCA, or anyone else. I am a patient, not a medical professional, and despite best efforts, I cannot guarantee that every detail was captured perfectly. Furthermore, optimal treatment of kidney cancer is often controversial, and you should not take what you find here to be the final word on any subject. If you have specific questions, particularly about therapies mentioned, I would encourage you to contact the speaker directly for more detail. Input from other attendees to either make corrections or augment the content is encouraged. Editing and HTML by Steve Dunn. Occasional "Editor's notes" appear in red |
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.