Multiple Myeloma: Future Directions in Autologous Transplantation and Novel Agents

Abstract

INTRODUCTION induction regimen even in the novel era. Therefore, the most Autologous hematopoietic cell transplantation (AHCT) in the 1990s and the advent of “novel” therapy, such as immune modulators and proteasome inhibitors, in the 2000s have led to impressive gains in the treatment of multiple myeloma (MM) [1,2]. In the prenovel drug era, the therapy paradigm composed of induction followed by planned AHCT in eligible patients, denoted as “upfront” or early AHCT, aimed at achieving a deeper disease response and longer survival. With modern induction therapies incorporating novel drugs, the timing and need for AHCT is increasingly debated because an additional survival benefit for early AHCT has not been established with modern induction regimens. Routine post-transplant consolidation and maintenance are new trends in AHCT-based treatment of MM. Second-generation immune modulators and proteasome inhibitors, sensitive prognostic schema, and disease-monitoring techniques are also changing the treatment landscape. This session at the tandem BMT meetings explores the relevance and future of early AHCT in MM, the role of consolidation/maintenance post-transplant, and new drug development.