Stem-cell transplantation in multiple myeloma

Best Pract Res Clin Haematol. 2005;18(4):603-18. doi: 10.1016/j.beha.2005.01.005.

Abstract

In patient with newly diagnosed multiple myeloma (MM), randomized studies have shown that autologous stem-cell transplantation (ASCT) is superior to conventional chemotherapy, and ASCT is now standard care, at least for younger patients. The best conditioning regimen is melphalan 200 mg/m2, and the best stem-cell source is unselected peripheral progenitor cells. Recent results of the IFM94 trial show that double ASCT is superior to single ASCT, at least in patients who do not achieve a 90% response after one transplant. By combining biologic markers (beta2-microglobulin, albumin) and genetic markers (hypodiploidy, chromosome 13 deletion) it is possible to accurately predict prognosis after ASCT. The results of allogeneic SCT remain disappointing due to a high transplant mortality. Strategies combining ASCT and reduced-intensity allogeneic SCT are currently being studied.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis
  • Genetic Markers
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / therapy*
  • Prognosis
  • Transplantation Conditioning / methods

Substances

  • Biomarkers
  • Genetic Markers