title: Stem Cell Transplantation in Multiple Myeloma.
abstract: High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) remains the standard of care for patients younger than 65 years of age with multiple myeloma (MM). However, this therapeutic approach has undergone substantial advances in this last decade, mainly due to the introduction of new drugs such as thalidomide, lenalidomide and bortezomib. These new drugs, in different combinations, have shown to significantly increase response rates after induction therapy and ASCT. Moreover, the positive results obtained with these agents in consolidation and maintenance strategies after ASCT strongly support the concept of continuous therapy, whose ultimate goal is the long-term control of the disease and the improvement of outcome. Preliminary data from studies investigating next generation proteasome inhibitors, such as carfilzomib and ixazomib, used upfront as well as at subsequent therapeutic lines, demonstrate the possibility of achieving molecular remission in most of the patients. The deeper responses obtained with new drugcombinations questioned the role of ASCT, and large, ongoing, phase 3 trials will shed light on the role and the timing of ASCT.
authors.affiliation: Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona. Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Offidani
authors.affiliation: Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona. Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gentili
authors.affiliation: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino. Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gay
authors.affiliation: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino. Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Aghemo
authors.affiliation: Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona. Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Maracci
authors.affiliation: Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona. Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Corvatta
authors.affiliation: Division of Hematology, University of Torino, Via Genova 3, 10126 Torino. Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D064592:Autografts; D000069286:Bortezomib / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D060830:Consolidation Chemotherapy / Q000379:methods; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014182:Transplantation, Autologous / Q000379:methods
chemical_list: D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide
keywords: ASCT; Stem cell transplantation; carfilzomib; ixazomib.; multiple myeloma; proteasome inhibitors