Results of high-dose treatment with autologous stem cell support in patients with multiple myeloma.
The introduction of high-dose treatment (HDT) with autologous hematopoietic stem cell support in patients with multiple myeloma (MM), although curative in only a minority of patients, has led to significantly longer event-free (EFS) and overall survival (OS) and likely improved quality of life compared with conventional chemotherapy. However, several issues remain unsettled. We review the current knowledge with respect to transplantation-related controversies, such as intensity of cytoreductive therapy (single v tandem transplants), optimal timing of the procedure, and potential benefit of graft purging and posttransplant consolidation chemotherapy. Special emphasis is placed on the safety and efficacy of transplant in elderly patients and in those with impaired renal function, who are usually excluded from the most effective therapy.
Fassas
A
A
Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Tricot
G
G
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D014182:Transplantation, Autologous