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Stem Cell Transplantation in Multiple Myeloma

[ Vol. 17 , Issue. 9 ]

Author(s):

Massimo Offidani, Silvia Gentili, Francesca Gay, Elena Aghemo, Laura Maracci, Laura Corvatta and Antonio PalumboPages 769-781 (13)

Abstract:


High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) remains the standard of care for patients younger than 65 years of age with multiple myeloma (MM). However, this therapeutic approach has undergone substantial advances in this last decade, mainly due to the introduction of new drugs such as thalidomide, lenalidomide and bortezomib. These new drugs, in different combinations, have shown to significantly increase response rates after induction therapy and ASCT. Moreover, the positive results obtained with these agents in consolidation and maintenance strategies after ASCT strongly support the concept of continuous therapy, whose ultimate goal is the long-term control of the disease and the improvement of outcome. Preliminary data from studies investigating next generation proteasome inhibitors, such as carfilzomib and ixazomib, used upfront as well as at subsequent therapeutic lines, demonstrate the possibility of achieving molecular remission in most of the patients. The deeper responses obtained with new drugcombinations questioned the role of ASCT, and large, ongoing, phase 3 trials will shed light on the role and the timing of ASCT.

Keywords:

Stem cell transplantation, multiple myeloma, ASCT, proteasome inhibitors, carfilzomib, ixazomib.

Affiliation:

Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona, Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona, Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona, Clinica di Ematologia AOU Ospedali Riuniti di Ancona, Ancona, Division of Hematology, University of Torino, Via Genova 3, 10126 Torino

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