Abstract
High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation is considered the standard of care for multiple myeloma patients who are eligible for transplantation. The process of autografting comprises the following steps: control of the primary disease by using a certain induction therapeutic protocol, mobilization of stem cells, collection of mobilized stem cells by apheresis, cryopreservation of the apheresis product, administration of high-dose pretransplant conditioning therapy, and finally infusion of the cryopreserved stem cells after thawing. However, in cancer centers that treat patients with multiple myeloma and have transplantation capabilities but lack or are in the process of acquiring cryopreservation facilities, alternatively noncryopreserved autologous stem cell therapy has been performed with remarkable success as the pretransplant conditioning therapy is usually brief.
Highlights
Multiple myeloma (MM) accounts for 1% of all cancers and about 10% of all hematologic malignancies [1]
Since the mid-1990s, high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation has been considered the standard of care for frontline therapy in MM patients who are eligible for transplantation [18]
Mobilization of stem cells prior to stem cell collection and auto-HSCT in patients with MM is generally composed of 2 parts: the first part comprises the use of certain chemotherapeutic agents that include a single agent like cyclophosphamide or multiple agents in various combinations, with different dose schedules such as VAD, CD, CAD, IVE, EDAP, CDVP, and VTD-PACE, and the second part is composed of administration of growth factors such as granulocyte colony-stimulating factor, pegylated G-CSF, and plerixafor (Mozobil) in case of poor mobilization [27,28,29,30,31,32,33,34,35,36,37,38,39,40]
Summary
Multiple myeloma (MM) accounts for 1% of all cancers and about 10% of all hematologic malignancies [1]. It is characterized by neoplastic proliferation of a clone of plasma cells producing a monoclonal immunoglobulin and can present as a single lesion (plasmacytoma) or multiple lesions (MM). Once the diagnosis of MM is made, the patient undergoes staging evaluation in order to start an appropriate line of therapy. Gene expression profiling and plasma cell labeling index can identify high-risk groups and select the most appropriate novel therapies to be used [1,2,3,4,5,6]
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