title: Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study.
abstract: Long-term follow-up of prospective studies comparing allogeneic transplantation to autologous transplantation in multiple myeloma is few and controversial. This is an update at a median follow-up of 96 months of the European Group for Blood and Marrow Transplantation Non-Myeloablative Allogeneic stem cell transplantation in Multiple Myeloma (NMAM)2000 study that prospectively compares tandem autologous/reduced intensity conditioning allogeneic transplantation (auto/RICallo) to autologous transplantation alone (auto). There are 357 myeloma patients up to age 69 years enrolled. Patients with an HLA-identical sibling were allocated to auto/RICallo (n = 108) and those without to auto alone (n = 249). At 96 months progression-free survival (PFS) and overall survival (OS) were 22% and 49% vs 12% (P = .027) and 36% (P = .030) with auto/RICallo and auto respectively. The corresponding relapse/progression rate (RL) was 60% vs 82% (P = .0002). Non-relapse mortality at 36 months was 13% vs 3% (P = .0004). In patients with the del(13) abnormality corresponding PFS and OS were 21% and 47% vs 5% (P = .026), and 31% (P = .154). Long-term outcome in patients with multiple myeloma was better with auto/RICallo as compared with auto only and the auto/RICallo approach seemed to overcome the poor prognostic impact of del(13) observed after autologous transplantation. Follow up longer than 5 years is necessary for correct interpretation of the value of auto/RICallo in multiple myeloma.
authors.affiliation: Department of Medicine, Karolinska Institute at Huddinge and Solna, Stockholm, Sweden.gosta.gahrton@ki.se
authors.forename: Gösta
authors.initials: G
authors.lastname: Gahrton
authors.forename: Simona
authors.initials: S
authors.lastname: Iacobelli
authors.forename: Bo
authors.initials: B
authors.lastname: Björkstrand
authors.forename: Ute
authors.initials: U
authors.lastname: Hegenbart
authors.forename: Astrid
authors.initials: A
authors.lastname: Gruber
authors.forename: Hildegard
authors.initials: H
authors.lastname: Greinix
authors.forename: Liisa
authors.initials: L
authors.lastname: Volin
authors.forename: Franco
authors.initials: F
authors.lastname: Narni
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Carella
authors.forename: Meral
authors.initials: M
authors.lastname: Beksac
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Milone
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Stefan
authors.initials: S
authors.lastname: Schönland
authors.forename: Kristina
authors.initials: K
authors.lastname: Friberg
authors.forename: Anja
authors.initials: A
authors.lastname: van Biezen
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
authors.forename: Curly
authors.initials: C
authors.lastname: Morris
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.forename: Laurent
authors.initials: L
authors.lastname: Garderet
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000601:surgery*; D013995:Time; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome