A comparison of allografting with autografting for newly diagnosed myeloma.

@article{Bruno2007ACO,
  title={A comparison of allografting with autografting for newly diagnosed myeloma.},
  author={Benedetto Bruno and Marcello Rotta and Francesca Patriarca and Nicola Mordini and Bernardino Allione and Fabrizio Carnevale-Schianca and Luisa Giaccone and Roberto Sorasio and Paola Omedé and Ileana Baldi and Sara Bringhen and Massimo Massaia and Massimo Aglietta and Alessandro Levis and Andrea Gallamini and Renato Fanin and Antonio Palumbo and Rainer F Storb and Giovannino Ciccone and Mario Boccadoro},
  journal={The New England journal of medicine},
  year={2007},
  volume={356 11},
  pages={
          1110-20
        }
}
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… 

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References

SHOWING 1-10 OF 35 REFERENCES
Allografting with nonmyeloablative conditioning following cytoreductive autografts for the treatment of patients with multiple myeloma.
TLDR
Despite being evaluated in elderly patients with MM, this 2-step approach has reduced the acute toxicities of allogeneic HCT while achieving potent antitumor activities.
Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect
TLDR
It is confirmed that early allografting in MM can yield toxicity rates significantly lower than those associated with historical cohorts, and the hypothesis that cumulative chemotoxicity has a negative influence on mortality and survival rates is supported.
Autologous stem cell transplantation followed by a dose-reduced allograft induces high complete remission rate in multiple myeloma.
TLDR
The tandem auto-allotransplant protocol is highly active and provides rapid engraftment with complete donor chimerism and tolerable toxicity and response to a dose-reduced allograft after cytoreductive autografting.
Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma.
TLDR
In patients with high-risk de novo MM, the combination of ASCT followed by dose-reduced allogeneic transplantation was not superior to tandem dose-intensified, melphalan-based ASCT.
Single versus double autologous stem-cell transplantation for multiple myeloma.
TLDR
As compared with a single autologous stem-cell transplantation after high-dose chemotherapy, double transplantation improves overall survival among patients with myeloma, especially those who do not have a very good partial response after undergoing one transplantation.
Allogeneic marrow transplantation for multiple myeloma: an analysis of risk factors on outcome.
TLDR
It is indicated that allografting for patients with MM can result in long-term disease-free survival for a minority of patients, and efforts to reduce transplant-related mortality should focus on earlier transplantation, less toxic treatment regimens, better supportive care, and improved prevention and treatment of graft-versus-host disease (GVHD).
Graft-versus-myeloma effect: proof of principle.
TLDR
This report provides the first direct evidence of a graft-versus-myeloma effect after allogenic transplantation in a 40-year-old patient with myeloma refractory to standard chemotherapy and autologous transplantation.
Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trial.
TLDR
Intention-to-treat analysis revealed that the 4-year disease-free survival (DFS) rate of patients with a donor versus those without a donor was 52.2% versus 42.2%, and the strategy to perform early allo-SCT led to better overall results than auto-S CT, especially for younger patients or those with bad/very bad risk cytogenetics.
A comparison of allogeneic bone marrow transplantation, autologous bone marrow transplantation, and aggressive chemotherapy in children with acute myeloid leukemia in remission.
TLDR
Patients receiving intensive-timing induction therapy had superior long-term survival irrespective of postremission regimen received, and allogeneic BMT remains the treatment of choice for children and adolescents with AML in remission, when a matched related donor is available.
Molecular and clinical remissions in multiple myeloma: role of autologous and allogeneic transplantation of hematopoietic cells.
  • P. Corradini, C. Voena, A. Pileri
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1999
TLDR
This is the first large study of molecular remissions in myeloma patients to use a PCR-based approach utilizing patient-specific tumor markers, and the sizeable fraction of patients who achieved molecular remission after allografting with peripheral blood progenitor cells represents a promising finding in an incurable disease.
...
...