Stem cell transplantation for multiple myeloma.
OBJECTIVE
Autologous stem cell transplantation (SCT) has been an integral part of the management of multiple myeloma, especially for younger patients. During the past decade, several highly effective therapies have become available for treatment of myeloma, raising questions about the role of SCT for its management. This review focuses on recent findings in the context of previous studies demonstrating a benefit for SCT compared with conventional therapies.


RESULTS
Recent clinical trials have primarily focused on improving patient outcome by integrating the novel agents into various stages of myeloma therapy, including initial therapy resulting in improvement of disease control at the time of SCT, incorporation into conditioning regimens and finally, using maintenance approaches to prolong the response from SCT. In addition, recent trials also have demonstrated a potential role for tandem SCT in selected patients. However, the role of allogeneic SCT still remains to be better defined.


CONCLUSIONS
Patients with myeloma have more effective choices for therapy today and better outcome. Recent and ongoing trials will allow better selection of therapy, preferably in an individualized fashion, potentially translating into prolonged survival.
Kumar
Shaji
S
Division of Hematology, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kumar.shaji@mayo.edu
D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D009101:Multiple Myeloma / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome