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[Hemopoietic stem cell transplantation for multiple myeloma-review].

Wen-Ming Chen

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Abstract

In the absence of significant improvement of disease-free survival (DFS) and overall survival (OS) by conventional chemotherapy, high dose chemotherapy in combination with hematopoietic stem cell transplantation has been increasingly used in the past decade for multiple myeloma (MM). Autologous stem cell transplantation (ASCT) was one of the most widely used methods in the treatment of MM. The patients who received ASCT may achieve a very good remission rate. ASCT may improve DFS but its application in clinic was limited by its high relapse rate. Tandem transplantation was feasible by its significant improvement of complete remission, but needed further evaluation. Allogeneic stem cell transplantation (Allo-SCT) has graft-versus-myeloma (GVM) effect, and provides molecular remission in about one third patients. It can only be offered to a small proportion of patients because of its high transplant-related mortality (TRM). Non-myeloablative transplantation is an attractive alternative tested currently in frontline treatment because of its GVM effect and low TRM.

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What this paper is about

In the absence of significant improvement of disease-free survival (DFS) and overall survival (OS) by conventional chemotherapy, high dose chemotherapy in combination with hematopoietic stem cell transplantation has been increasingly used in the past decade for multiple myeloma (MM). Autologous stem cell transplantation (ASCT) was one of the most widely used methods in the treatment of MM. The patients who received ASCT may achieve a very good remission rate. ASCT may improve DFS but its application in clinic was limited by its high relapse rate. Tandem transplantation was feasible by its significant improvement of complete remission, but needed further evaluation. Allogeneic stem cell transplantation (Allo-SCT) has graft-versus-myeloma (GVM) effect, and provides molecular remission in about one third patients. It can only be offered to a small proportion of patients because of its high transplant-related mortality (TRM). Non-myeloablative transplantation is an attractive alternative tested currently in frontline treatment because of its GVM effect and low TRM.

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Available abstract

In the absence of significant improvement of disease-free survival (DFS) and overall survival (OS) by conventional chemotherapy, high dose chemotherapy in combination with hematopoietic stem cell transplantation has been increasingly used in the past decade for multiple myeloma (MM). Autologous stem cell transplantation (ASCT) was one of the most widely used methods in the treatment of MM. The patients who received ASCT may achieve a very good remission rate. ASCT may improve DFS but its application in clinic was limited by its high relapse rate. Tandem transplantation was feasible by its significant improvement of complete remission, but needed further evaluation. Allogeneic stem cell transplantation (Allo-SCT) has graft-versus-myeloma (GVM) effect, and provides molecular remission in about one third patients. It can only be offered to a small proportion of patients because of its high transplant-related mortality (TRM). Non-myeloablative transplantation is an attractive alternative tested currently in frontline treatment because of its GVM effect and low TRM.

Key concepts: Multiple myeloma, Medicine, Transplantation, Stem cell, Autologous stem-cell transplantation, Oncology, Hematopoietic stem cell transplantation, Chemotherapy

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