Authors: Jean-Sébastien Claveau, Francis K. Buadi & Shaji Kumar
Major progress in the treatment of multiple myeloma has been made in the last several years. However, myeloma remains incurable and patients with high-risk cytogenetics or advanced stage disease have an even worsen survival. Only allogeneic transplantation may have curative potential in some patients. However, the high non-relapse mortality and incidence of chronic graft-versus-host disease have raised controversy regarding this procedure. In this review, we will address the role of upfront and delayed allogeneic transplant.
Key Summary Points
Most patients with multiple myeloma will eventually relapse and die from their disease.
Allogeneic hematopoietic cell transplant is currently the only potentially curative therapy, supporting the existence of a graft-versus-myeloma effect.
Access to an algorithm regarding clinical utilization of allogeneic transplant would benefit clinicians and researchers.
New strategies are necessary to make allogeneic hematopoietic cell transplantation safer while reducing non-relapse mortality and chronic graft-versus-host disease.
In young patients with ultra-high-risk disease, upfront allogeneic transplantation could be a valuable option in the context of clinical trials.