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Blood, 2 April 2009, Vol. 113, No. 14, pp. 3375-3382. Prepublished online as a Blood First Edition Paper on December 8, 2008; DOI 10.1182/blood-2008-07-167379. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-07-167379v1 113/14/3375    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bruno, B. Articles by Boccadoro, M. Search for Related Content PubMed PubMed Citation Articles by Bruno, B. Articles by Boccadoro, M. Related Collections Transplantation Free Research Articles Lymphoid Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Nonmyeloablative allografting for newly diagnosed multiple myeloma: the experience of the Gruppo Italiano Trapianti di Midollo Benedetto Bruno1, Marcello Rotta1, Francesca Patriarca2, Daniele Mattei3, Bernardino Allione4, Fabrizio Carnevale-Schianca5, Roberto Sorasio1, Alessandro Rambaldi6, Marco Casini7, Matteo Parma8, Pasqua Bavaro9, Francesco Onida10, Alessandro Busca11, Luca Castagna12, Edoardo Benedetti13, Anna Paola Iori14, Luisa Giaccone1, Antonio Palumbo1, Paolo Corradini15, Renato Fanin2, David Maloney16, Rainer Storb16, Ileana Baldi17, Umberto Ricardi18, and Mario Boccadoro1 1 Division of Hematology, S Giovanni Battista Hospital, University of Torino, Torino, Italy; 2 Division of Hematology, Department of Clinical and Morphological Researches, University of Udine, Udine, Italy; 3 Division of Hematology, S Croce e Carle Hospital, Cuneo, Italy; 4 Division of Hematology, SS Antonio e Biagio Hospital, Alessandria, Italy; 5 Division of Oncology, Institute for Cancer Research and Treatment (IRCC), Candiolo, Italy; 6 Division of Hematology, Ospedali Riuniti, Bergamo, Italy; 7 Division of Hematology, Regional Hospital, Bolzano, Italy; 8 Division of Hematology, S Gerardo Hospital, University of Milano, Bicocca, Monza, Italy; 9 Division of Hematology, Ospedale Civile, Pescara, Italy; 10 Division of Hematology at the Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano, Italy; 11 Division of Hematology, S Giovanni Battista Hospital, Torino, Italy; 12 Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milano, Italy; 13 Division of Hematology, S Chiara Hospital, University of Pisa, Pisa, Italy; 14 Division of Hematology, University La Sapienza, Roma, Italy; 15 Division of Hematology, Istituto Nazionale Tumori, University of Milano, Milano, Italy; 16 Fred Hutchinson Cancer Research Center, University of Washington, Seattle; 17 Unità di Epidemiologia dei Tumori, S G B Hospital and CPO, Piemonte, Italy; and 18 Radiation Oncology Unit, S Giovanni Battista Hospital, University of Torino, Torino, Italy Despite recent advances, allografting remains the only potential cure for myeloma. From July 1999 to June 2005, 100 newly diagnosed patients younger than 65 years were enrolled in a prospective multicenter study. First-line treatment included vincristin, adriamycin, and dexamethasone (VAD)–based induction chemotherapy, a cytoreductive autograft (melphalan 200 mg/m2) followed by a single dose of nonmyeloablative total body irradiation and allografting from an human leukocyte antigen (HLA)–identical sibling. Primary end points were the overall survival (OS) and event-free survival (EFS) from diagnosis. After a median follow-up of 5 years, OS was not reached, and EFS was 37 months. Incidences of acute and chronic graft-versus-host disease (GVHD) were 38% and 50%, respectively. Complete remission (CR) was achieved in 53% of patients. Profound cytoreduction (CR or very good partial remission) before allografting was associated with achievement of posttransplantation CR (hazard ratio [HR] 2.20, P = .03) and longer EFS (HR 0.33, P < .01). Conversely, development of chronic GVHD was not correlated with CR or response duration. This tandem transplantation approach allows prolonged survival and long-term disease control in patients with reduced tumor burden at the time of allografting. We are currently investigating the role of "new drugs" in intensifying pretransplantation cytoreduction and posttransplantation graft-versus-myeloma effects to further improve clinical outcomes. (http://ClinicalTrials.gov; NCT-00702247.) CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Reduced-intensity allogeneic transplantation for myeloma: reality bites A. Keith Stewart Blood 2009 113: 3135-3136. [Full Text] [PDF] This article has been cited by other articles: C. Fionda, A. Soriani, G. Malgarini, M. L. Iannitto, A. Santoni, and M. Cippitelli Heat Shock Protein-90 Inhibitors Increase MHC Class I-Related Chain A and B Ligand Expression on Multiple Myeloma Cells and Their Ability to Trigger NK Cell Degranulation J. Immunol., October 1, 2009; 183(7): 4385 - 4394. [Abstract] [Full Text] [PDF] A. K. Stewart Reduced-intensity allogeneic transplantation for myeloma: reality bites Blood, April 2, 2009; 113(14): 3135 - 3136. [Full Text] [PDF]

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