Stem-Cell Autograft-Allograft Improves Myeloma Survival

Survival longer in patients receiving HLA-identical stem cells from sibling than double-autologous transplant

WEDNESDAY, March 14 (HealthDay News) -- Patients with newly diagnosed myeloma who receive a hematopoietic stem-cell autograft and a stem-cell allograft from an HLA-identical sibling tend to survive longer than patients who undergo a double-autologous stem-cell transplant, according to study findings published in the March 15 issue of the New England Journal of Medicine.

Benedetto Bruno, M.D., Ph.D., from the University of Turin in Italy, and colleagues compared survival in patients with newly diagnosed multiple myeloma. The 58 patients with an HLA-identical sibling were given a hematopoietic stem-cell autograft and an allograft from the sibling, while 46 patients without a matched sibling received two tandem autografts. All patients were first treated with chemotherapy and autologous stem-cell rescue.

After a median follow-up of 45 months, the researchers found that the median overall and event-free survival were significantly longer in patients with an HLA-identical sibling. Treatment-related mortality was not significantly different between the two groups, although disease-related mortality was higher in patients receiving the double tandem autografts (43 percent versus 7 percent). In the autograft-allograft group, the combined incidence of grade II, III and IV graft-versus-host disease was 43 percent, and 36 percent of patients were in complete remission after a median of 38 months.

"Among patients with newly diagnosed myeloma, survival in recipients of a hematopoietic stem-cell autograft followed by a stem-cell allograft from an HLA-identical sibling is superior to that in recipients of tandem stem-cell autografts," Bruno and colleagues conclude.

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