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Long-term follow-up of a comparison of nonmyeloablative allografting with autografting for newly diagnosed myeloma

2011; Elsevier BV; Volume: 117; Issue: 24 Linguagem: Inglês

10.1182/blood-2011-03-339945

1528-0020

Luisa Giaccone, Barry E. Storer, Francesca Patriarca, Marcello Rotta, Roberto Sorasio, Bernardino Allione, Fabrizio Carnevale‐Schianca, Moreno Festuccia, Lucia Brunello, Paola Omedè, Sara Bringhen, Massimo Aglietta, Alessandro Levis, Nicola Mordini, Andrea Gallamini, Renato Fanin, Massimo Massaia, Antonio Palumbo, Giovannino Ciccone, Rainer Storb, Ted Gooley, Mario Boccadoro, Benedetto Bruno,

Myeloproliferative Neoplasms: Diagnosis and Treatment

Abstract 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.