title: International Myeloma Working Group consensus approach to the treatment of multiple myeloma patients who are candidates for autologous stem cell transplantation.
abstract: The role of high-dose therapy followed by autologous stem cell transplantation (ASCT) in the treatment of multiple myeloma (MM) continues to evolve in the novel agent era. The choice of induction therapy has moved from conventional chemotherapy to newer regimens incorporating the immunomodulatory derivatives thalidomide or lenalidomide and the proteasome inhibitor bortezomib. These drugs combine well with traditional therapies and with one another to form various doublet, triplet, and quadruplet regimens. Up-front use of these induction treatments, in particular 3-drug combinations, has affected unprecedented rates of complete response that rival those previously seen with conventional chemotherapy and subsequent ASCT. Autotransplantation applied after novel-agent-based induction regimens provides further improvement in the depth of response, a gain that translates into extended progression-free survival and, potentially, overall survival. High activity shown by immunomodulatory derivatives and bortezomib before ASCT has recently led to their use as consolidation and maintenance therapies after autotransplantation. Novel agents and ASCT are complementary treatment strategies for MM. This article reviews the current literature and provides important perspectives and guidance on the major issues surrounding the optimal current management of younger, transplantation-eligible MM patients.
authors: Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors: Michele
authors: M
authors: Cavo
authors: S Vincent
authors: SV
authors: Rajkumar
authors: Antonio
authors: A
authors: Palumbo
authors: Philippe
authors: P
authors: Moreau
authors: Robert
authors: R
authors: Orlowski
authors: Joan
authors: J
authors: Bladé
authors: Orhan
authors: O
authors: Sezer
authors: Heinz
authors: H
authors: Ludwig
authors: Meletios A
authors: MA
authors: Dimopoulos
authors: Michel
authors: M
authors: Attal
authors: Pieter
authors: P
authors: Sonneveld
authors: Mario
authors: M
authors: Boccadoro
authors: Kenneth C
authors: KC
authors: Anderson
authors: Paul G
authors: PG
authors: Richardson
authors: William
authors: W
authors: Bensinger
authors: Hans E
authors: HE
authors: Johnsen
authors: Nicolaus
authors: N
authors: Kroeger
authors: Gösta
authors: G
authors: Gahrton
authors: P Leif
authors: PL
authors: Bergsagel
authors: David H
authors: DH
authors: Vesole
authors: Hermann
authors: H
authors: Einsele
authors: Sundar
authors: S
authors: Jagannath
authors: Ruben
authors: R
authors: Niesvizky
authors: Brian G M
authors: BG
authors: Durie
authors: Jesus
authors: J
authors: San Miguel
authors: Sagar
authors: S
authors: Lonial
mesh_terms: D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous