title: [Positioning of autoPBSCT in the treatment of multiple myeloma in the era of new drugs].
abstract: At present, a standard therapy for de novo multiple myeloma (MM) patients under 65 years old without severe comorbidity is an upfront high dose chemotherapy (HDCT) with MEL200 combined with auto peripheral blood stem cell transplantation (autoPBSCT) after the induction therapy. However, three-drug regimens including new drugs such as bortezomib (Bor) and lenalidomide (Len) have been shown to achieve deep molecular responses as an induction therapy for de novo MM patients. Several phase II studies using RVD (Len, Bor, dexamethasone) or CRd (carfilzomib, Len, dexamethasone) showed very promising data, suggesting that the continuance of these regimens might be able to substitute HDCT. In contrast, early HDCT was shown to be better than late HDCT in another trials. So, the upfront autoPBSCT is still needed even in the era of new drugs. However, future prospective phase III randomized trials using new drugs such as carfilzomib and ponalidomide might rewrite the present evidence.
authors.forename: Itaru
authors.initials: I
authors.lastname: Matsumura
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D064592:Autografts; D002986:Clinical Trials as Topic; D006801:Humans; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents