The emerging role of stem-cell transplantation for multiple myeloma and other plasma cell dyscrasias

Abstract

 Treatment outcomes of multiple myeloma (MM) have been dramatically improved in past 20 years. IFM/DFCI group reported that triplet induction (bortezomib, lenalidomide, and dexamethasone) followed by up-front high-dose melphalan and autologous stem-cell transplantation (HDM/ASCT) and maintenance therapy lead to median PFS of 50 months. Therefore, up-front HDM/ASCT is considered as standard care even in the era of novel agents. Daratumumab, lenalidomide, and dexamethasone have also been reported to prolong PFS for newly diagnosed transplant-ineligible MM. Quadruplet induction including anti-CD38 antibody will be approved even for transplant-eligible MM in near future. The role of HDM/ASCT for the treatment for AL amyloidosis and POEMS syndrome is also discussed.