Allogeneic stem cell transplantation for multiple myeloma: is there a future? Bone Marrow Transplant 2016 Apr;51(4):492-500
Date
01/05/2016Pubmed ID
26726943DOI
10.1038/bmt.2015.325Scopus ID
2-s2.0-84953338728 (requires institutional sign-in at Scopus site) 52 CitationsAbstract
Despite remarkable progress in survival with the availability of novel agents, an overwhelming majority of patients with multiple myeloma (MM) relapse and the curability of MM remains limited. Genetically defined high-risk MM represents a subgroup with an aggressive disease course despite novel agents. Allogeneic hematopoietic cell transplantation (allo-SCT) is a potentially curative option in MM that has several advantages including a tumor-free graft, and the potential for sustained immune-mediated disease control. However, historically high treatment-related mortality (TRM) and conflicting reports from prospective studies in the United States and European Union have limited the utilization of this modality. Meanwhile, newer preparative regimens, planned maintenance strategies and improvements in supportive care have led to a decline in TRM and better survival in recent years. The allo-SCT platform also provides additional options of immunotherapy at relapse including donor lymphocyte infusions, immunomodulatory drug maintenance and withdrawal of immune suppression. In this article, we provide an in-depth review of literature for allo-SCT and other immunotherapy options, as well as the authors' approach to using allo-SCT in MM.
Author List
Dhakal B, Vesole DH, Hari PNAuthors
Binod Dhakal MD Associate Professor in the Medicine department at Medical College of WisconsinParameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AllograftsDisease-Free Survival
Graft vs Tumor Effect
Hematopoietic Stem Cell Transplantation
Humans
Immunologic Factors
Lymphocyte Transfusion
Multiple Myeloma
Survival Rate
