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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 (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 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 Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 18, 2008 Accepted November 25, 2008 Non-myeloablative allografting for newly diagnosed multiple myeloma: the experience of the Gruppo Italiano Trapianti di Midollo Benedetto Bruno*, Marcello Rotta, Francesca Patriarca, Daniele Mattei, Bernardino Allione, Fabrizio Carnevale-Schianca, Roberto Sorasio, Alessandro Rambaldi, Marco Casini, Matteo Parma, Pasqua Bavaro, Francesco Onida, Alessandro Busca, Luca Castagna, Edoardo Benedetti, Anna Paola Iori, Luisa Giaccone, Antonio Palumbo, Paolo Corradini, Renato Fanin, David Maloney, Rainer Storb, Ileana Baldi, Umberto Ricardi, and Mario Boccadoro Division of Hematology, S. Giovanni Battista Hospital, University of Torino, Torino, Italy Division of Hematology, Department of Clinical and Morphological Researches, University of Udine, Udine, Italy Division of Hematology, S. Croce e Carle Hospital, Cuneo, Italy Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy Division of Oncology, IRCC, Candiolo, Italy Division of Hematology, Ospedali Riuniti, Bergamo, Italy Division of Hematology, Regional Hospital, Bolzano, Italy Division of Hematology, S. Gerardo Hospital, University of Milano, Bicocca, Monza, Italy Division of Hematology, Ospedale Civile, Pescara, Italy Division of Hematology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano, Italy Division of Hematology, S. Giovanni Battista Hospital, Torino, Italy Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Italy Division of Hematology, S. Chiara Hospital, University of Pisa, Pisa, Italy Division of Hematology, University La Sapienza, Roma, Italy Division of Hematology, Istituto Nazionale Tumori, University of Milano, Milano, Italy Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, United States Unita di Epidemiologia dei Tumori, S.G.B. Hospital and CPO Piemonte, Torino, Italy Radiation Oncology Unit, S. Giovanni Battista Hospital, University of Torino, Torino, Italy * Corresponding author; email: benedetto.bruno{at}unito.it. 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 multi-center 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 non-myeloablative total body irradiation and allografting from an HLA-identical sibling. Primary endpoints were overall (OS) and event-free (EFS) survivals 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-vs.-host disease (GHVD) were 38% and 50%, respectively. Complete remission (CR) was achieved in 53% of patients. Profound cytoreduction (CR or very good partial remission) prior to allografting was associated with achievement of post-transplant CR (HR 2.20, p=0.03) and longer EFS (HR 0.33, p<0.01). Conversely, development of chronic GVHD was not correlated with CR or response duration. This tandem transplant 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 pre-transplant cytoreduction and post-transplant graft-vs.-myeloma effects to further improve clinical outcomes. (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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