Abstract
Over the last two decades, the utilization of various novel therapies in the upfront or salvage settings has continued to improve survival outcomes for patients with Multiple Myeloma (MM). Thus, the conventional role for hematopoietic stem cell transplantation (HSCT) in MM either in the form of an autologous stem cell transplant (ASCT) or an allogeneic stem cell transplant (Allo-SCT) warrants re-evaluation, given the aforementioned clinical advances. Here, we present a consensus statement of our multidisciplinary group of over 30 Mayo Clinic physicians with a special interest in the care of patients with MM and provide evidence-based recommendations on the use of HSCT in MM. We specifically address topics that include the role and timing of an ASCT for MM in the era of novel agents, eligibility for an ASCT, post-ASCT consolidation, and maintenance options, and finally the utility of an upfront tandem ASCT, salvage second ASCT, and an allo-SCT in MM.
Highlights
Hematopoietic stem cell transplantation (HSCT) involves high-dose chemotherapy followed by infusion of procured autologous, allogeneic, or syngeneic stem cells
The therapeutic armamentarium for MM has evolved over the last two decades with the incorporation of numerous novel therapies such as proteasome inhibitors (PIs), immunomodulators (IMiDs), and monoclonal antibodies for the treatment of patients with newly diagnosed and relapsed MM [3, 4]. This has led to an improvement in the depth and duration of disease response that have eventually translated to an improved overall survival (OS) for patients with MM [5, 6]
Our multidisciplinary group of over 30 Mayo Clinic physicians at three different sites (Scottsdale, AZ; Jacksonville, FL; and Rochester, MN) with a special interest in the care of patients with MM have performed an extensive review of the literature with the aim of making evidence-based recommendations on the use of HSCT for the management of patients with MM
Summary
Hematopoietic stem cell transplantation (HSCT) involves high-dose chemotherapy followed by infusion of procured autologous, allogeneic, or syngeneic stem cells.
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