The role of autologous stem cell transplantation in multiple myeloma in the era of novel anti-myeloma agents

Haema 2013; 4(3):220-227

by Evangelos Terpos¹, Dimitrios Christoulas², Efstathios Kastritis¹

¹Department of Clinical Therapeutics, Medical School, National and Kapodistrian University of Athens
²Department of Haematology, 251 General Air Force Hospital, Athens, Greece

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Abstract

In the era of conventional chemotherapy high dose melphalan followed by autologous stem cell transplantation (ASCT) immediately after induction chemotherapy was the treatment of choice in patients younger than 65 years old with multiple myeloma (MM). The integration of novel agents (thalidomide, bortezomib and lenalidomide) in induction regimens has resulted in increased survival of patients with MM and raises questions about the role of ASCT in the treatment of MM. This review attempts to give answers regarding the optimal induction therapy in patients who are candidates for ASCT, the need of ASCT as intensification treatment, the importance of achieving deep remission in relation to overall survival and the role of consolidation and maintenance therapy after ASCT.