title: Consolidation and maintenance therapy for multiple myeloma after autologous transplantation: where do we stand?
abstract: Novel agents including proteasome inhibitors and immunomodulatory drugs are now routinely utilized as part of the induction regimen before transplantation and this has resulted in substantial improvements in the depth of response achieved before transplant. Given that depth of response is prognostic for overall outcome, a number of studies have been conducted or are ongoing to investigate the use of novel agents as consolidation and maintenance therapy after transplant. Most clinical trials have reported after consolidation and maintenance therapy an increased PFS and even overall survival in some of them. The use of post-autologous stem cell transplant consolidation and maintenance is an increasingly attractive concept. However, some side effects could be observed with such long-term therapy and many open questions are still under debate. The decision to administer consolidation and/or maintenance therapy will likely need to be guided by the individual patient situation. This review aims to analyze the currently available research evidence in this field.
authors.affiliation: 1] Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, APHP, Paris, France [2] Universite Pierre et Marie Curie, Paris, France [3] INSERM, UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Jerome Lipper Multiple Myeloma Center, Boston, MA, USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Richardson
authors.affiliation: Blood and Marrow Transplant Program, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: McCarthy
authors.affiliation: Hématologie Clinique, Hôpital Purpan, and Institut Universitaire du Cancer de Toulouse (IUCT), Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Attal
mesh_terms: D064592:Autografts; D060830:Consolidation Chemotherapy / Q000379:methods*; D018572:Disease-Free Survival; D006801:Humans; D060046:Maintenance Chemotherapy / Q000379:methods*; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D033581:Stem Cell Transplantation; D015996:Survival Rate