Journal
CURRENT OPINION IN ONCOLOGY
Volume 33, Issue 6, Pages 642-647Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/CCO.0000000000000783
Keywords
autologous transplant; high-dose melphalan; multiple myeloma; novel agents
Categories
Ask authors/readers for more resources
HDM-ASCT remains the standard of care for upfront treatment of newly diagnosed MM patients. Despite some unresolved issues, attempts to replace HDM-ASCT with novel-agent-based strategies have not been successful in terms of efficacy.
Purpose of review In this review, we discuss the most important aspects of the role of high-dose melphalan (HDM) and autologous stem-cell transplantation (ASCT) in the treatment of multiple myeloma (MM). Recent findings Almost 40 years after the publication of the first study on safety and efficacy of HDM and ASCT in MM patients, and despite the introduction of several drugs and combinations with various targets on the plasma cell and the surrounding microenvironment, HDM-ASCT still stands as a standard of care for the upfront treatment of newly diagnosed MM patients. Indeed, all attempts to replace HDM-ASCT with novel-agent-based, non-transplant strategies have failed to demonstrate their efficacy, at least in terms of progression-free survival. Despite such a long history in MM, a number of open issues regarding HDM-ASCT still exist, from the choice between using transplant in first-line therapy or at relapse to the use of tandem HDM-ASCT in high-risk patients. With the introduction of more and more effective multidrug regimens and of novel immunotherapeutic approaches, the challenge between transplant and non-transplant is not over yet.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available