Role of allogeneic stem cell transplantation in multiple myeloma.
Multiple myeloma remains incurable despite the use of high-dose therapy and autologous stem cell transplantation and the introduction of novel agents with high response rates. The use of an uncontaminated stem cell graft and the presence of a graft-versus-myeloma effect led to the use of allogeneic stem cell transplantation in myeloma, and it has been part of the therapeutic armamentarium for more than a decade. Early results were discouraging due to high transplantation-related mortality and high rates of graft-versus-host disease. More recently, better supportive care, increasing experience with this modality and its complications, use of reduced-intensity conditioning regimens, and its use earlier in the course of disease have led to improved outcomes. Patients with high-risk genetic and biochemical features do poorly with conventional therapies, and allogeneic transplantation offers the potential for long-term disease control.
Kumar
Shaji
S
Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. kumar.shaji@mayo.edu
D006801:Humans; D009101:Multiple Myeloma / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods* / Q000639:trends; D014184:Transplantation, Homologous / Q000379:methods* / Q000639:trends