TY - JOUR
T1 - Long-term follow-up of a comparison of nonmyeloablative allografting with autografting for newly diagnosed myeloma
AU - Giaccone, Luisa
AU - Storer, Barry
AU - Patriarca, Francesca
AU - Rotta, Marcello
AU - Sorasio, Roberto
AU - Allione, Bernardino
AU - Carnevale-Schianca, Fabrizio
AU - Festuccia, Moreno
AU - Brunello, Lucia
AU - Omedè, Paola
AU - Bringhen, Sara
AU - Aglietta, Massimo
AU - Levis, Alessandro
AU - Mordini, Nicola
AU - Gallamini, Andrea
AU - Fanin, Renato
AU - Massaia, Massimo
AU - Palumbo, Antonio
AU - Ciccone, Giovannino
AU - Storb, Rainer
AU - Gooley, Ted A.
AU - Boccadoro, Mario
AU - Bruno, Benedetto
PY - 2011/6/16
Y1 - 2011/6/16
N2 - Before the introduction of new drugs, we designed a trial where treatment of newly diagnosed myeloma patients was based on the presence or absence of HLA-identical siblings. First-line treatments included a cytoreductive autograft followed by a nonmyeloablative allograft or a second melphalan-based autograft. Here, we report long-term clinical outcomes and discuss them in the light of the recent remarkable advancements in the treatment of myeloma. After a median follow-up of 7 years, median overall survival (OS) was not reached (P = .001) and event-free survival (EFS) was 2.8 years (P = .005) for 80 patients with HLA-identical siblings and 4.25 and 2.4 years for 82 without, respectively. Median OS was not reached (P = .02) and EFS was 39 months (P = .02) in the 58 patients who received a nonmyeloablative allograft whereas OS was 5.3 years and EFS 33 months in the 46 who received 2 high-dose melphalan autografts. Among patients who reached complete remission in these 2 cohorts, 53% and 19% are in continuous complete remission. Among relapsed patients rescued with "new drugs," median OS from the start of salvage therapy was not reached and was 1.7 (P = .01) years, respectively. Allografting conferred a long-term survival and disease-free advantage over standard autografting in this comparative study.
AB - Before the introduction of new drugs, we designed a trial where treatment of newly diagnosed myeloma patients was based on the presence or absence of HLA-identical siblings. First-line treatments included a cytoreductive autograft followed by a nonmyeloablative allograft or a second melphalan-based autograft. Here, we report long-term clinical outcomes and discuss them in the light of the recent remarkable advancements in the treatment of myeloma. After a median follow-up of 7 years, median overall survival (OS) was not reached (P = .001) and event-free survival (EFS) was 2.8 years (P = .005) for 80 patients with HLA-identical siblings and 4.25 and 2.4 years for 82 without, respectively. Median OS was not reached (P = .02) and EFS was 39 months (P = .02) in the 58 patients who received a nonmyeloablative allograft whereas OS was 5.3 years and EFS 33 months in the 46 who received 2 high-dose melphalan autografts. Among patients who reached complete remission in these 2 cohorts, 53% and 19% are in continuous complete remission. Among relapsed patients rescued with "new drugs," median OS from the start of salvage therapy was not reached and was 1.7 (P = .01) years, respectively. Allografting conferred a long-term survival and disease-free advantage over standard autografting in this comparative study.
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U2 - 10.1182/blood-2011-03-339945
DO - 10.1182/blood-2011-03-339945
M3 - Article
C2 - 21490341
AN - SCOPUS:79959243080
VL - 117
SP - 6721
EP - 6727
JO - Blood
JF - Blood
SN - 0006-4971
IS - 24
ER -