Long term survival in three pancreatic cancer patients following Whipple’s procedure and allogeneic hematopoietic cell transplantation

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is associated with an extremely poor prognosis, with long-term survival being exceedingly rare. Here, we follow-up on three long-term survivors. Methods: This study initially included eight patients with PDAC who underwent radical resection via Whipple's procedure with no evidence of distant metastases. Two of these patients received allogeneic hematopoietic cell transplantation (HCT) in a previously published trial. The remaining six patients, who served as controls and did not receive HCT, died of progressive PDAC within one to four years. Additionally, a 60-year-old male with PDAC who underwent partial pancreatectomy and gastrectomy received HCT from a matched unrelated donor. Results: Patient 1 developed mild acute graft-versus-host disease (GVHD) of the skin, followed by chronic GVHD. He subsequently underwent surgery for oral cancer and remains alive 21 years after the initial PDAC diagnosis, with no evidence of recurrence. Patient 2 experienced severe acute gastrointestinal GVHD and recurrent chronic bronchiolitis obliterans. He died of esophageal cancer 19 years after PDAC diagnosis. Patient 3 experienced graft rejection and multiple medical complications, including radical surgery for colorectal cancer, yet remains cancer-free 15 years after PDAC diagnosis. Discussion: In conclusion, HCT may confer anticancer effects in patients with radically resected PDAC. Further investigations are warranted to confirm its therapeutic value.ClinicalTrials.gov Identifier: NCT02207985.