The role of tandem stem cell transplantation for multiple myeloma patients

Expert Opin Biol Ther. 2016;16(4):515-34. doi: 10.1517/14712598.2016.1136285. Epub 2016 Feb 6.

Abstract

Introduction: Autologous Stem Cell Transplantation (ASCT) represents the standard treatment in eligible "de-novo" multiple myeloma (MM) patients.

Areas covered: ASCT may be single or tandem, and a single ASCT can be followed by an allogeneic (Allo)-SCT. A systematic review has been conducted to examine the current evidence for the efficacy of using a tandem transplant strategy in MM.

Expert opinion: A tandem ASCT approach should be considered for all patients, although the benefit from the second ASCT in patients who are in complete remission or experience a very good partial response should be answered in a clinical trial. Recent results with the new induction regimens indicate that there is a role for tandem ASCT in the presence of adverse cytogenetic abnormalities. Planned AlloSCT after ASCT has not been found to be superior in the majority of studies and is not recommended outside of a clinical trial. However, single or tandem ASCT are both appropriate options and participation in prospective clinical trials should be encouraged to resolve the debate in the era of novel agents for MM.

Keywords: Autologous Stem Cell Transplantation; Multiple Myeloma; New Drugs; Single Transplant; Tandem Transplant.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Bone Marrow Transplantation / methods*
  • Combined Modality Therapy
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / surgery
  • Multiple Myeloma / therapy*
  • Remission Induction
  • Transplantation, Autologous

Substances

  • Antineoplastic Agents