A comparison of allografting with autografting for newly diagnosed myeloma

Benedetto Bruno, Marcello Rotta, Francesca Patriarca, Nicola Mordini, Bernardino Allione, Fabrizio Carnevale-Schianca, Luisa Giaccone, Roberto Sorasio, Paola Omedè, Ileana Baldi, Sara Bringhen, Massimo Massaia, Massimo Aglietta, Alessandro Levis, Andrea Gallamini, Renato Fanin, Antonio Palumbo, Rainer Storb, Giovannino Ciccone, Mario Boccadoro

Research output: Contribution to journalArticlepeer-review


Background: In this trial of the treatment of newly diagnosed multiple myeloma, we compared a protocol that entailed a hematopoietic stem-cell autograft followed by an allograft from an HLA-identical sibling with a protocol of tandem autografts. Methods: We enrolled 162 consecutive patients with newly diagnosed myeloma who were 65 years of age or younger and who had at least one sibling. All patients were initially treated with vincristine, doxorubicin, and dexamethasone, followed by melphalan and autologous stem-cell rescue. Patients with an HLA-identical sibling then received nonmyeloablative total-body irradiation and stem cells from the sibling. Patients without an HLA-identical sibling received two consecutive myeloablative doses of melphalan, each of which was followed by autologous stem-cell rescue. The primary end points were overall survival and event-free survival. Results: After a median follow-up of 45 months (range, 21 to 90), the median overall survival and event-free survival were longer in the 80 patients with HLA-identical siblings than in the 82 patients without HLA-identical siblings (80 months vs. 54 months, P=0.01; and 35 months vs. 29 months, P=0.02, respectively). Among patients who completed their assigned treatment protocols, treatment-related mortality did not differ significantly between the double-autologous-transplant group (46 patients) and the autograft-allograft group (58 patients, P=0.09), but disease-related mortality was significantly higher in the double-autologous-transplant group (43% vs. 7%, P

Original languageEnglish
Pages (from-to)1110-1120
Number of pages11
JournalNew England Journal of Medicine
Issue number11
Publication statusPublished - Mar 15 2007

ASJC Scopus subject areas

  • Medicine(all)


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