When to recommend a second autograft in patients with relapsed myeloma?

Leuk Lymphoma. 2017 Apr;58(4):781-787. doi: 10.1080/10428194.2016.1246729. Epub 2016 Nov 28.

Abstract

In the current evolving landscape of myeloma therapies, no recommended salvage strategy exists for patients with relapsed multiple myeloma (MM) after initial successful autologous stem cell transplantation (ASCT) and therapeutic options extend from conventional chemotherapy and novel agents to second autologous and allogeneic transplants. In this article, we summarize the documented evidence about the utilization of second ASCT in patients with relapsed MM after a primary auto-graft and discuss the correct timing for such a salvage approach, the individual characteristics of patients who will benefit more, as well as the therapeutic role of second ASCT in the modern era of forthcoming anti-myeloma treatments.

Keywords: Second ASCT; multiple myeloma; relapse.

Publication types

  • Review

MeSH terms

  • Clinical Decision-Making
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Maintenance Chemotherapy
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology*
  • Multiple Myeloma / therapy*
  • Prognosis
  • Recurrence
  • Retreatment
  • Salvage Therapy
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome