Stem-cell transplantation in multiple myeloma |
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Authors: | Harousseau Jean-Luc Moreau Philippe Attal Michel Facon Thierry Avet-Loiseau Hervé |
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Affiliation: | Department of Hematology, Hotel Dieu, Nantes, France. jlharousseau@sante.univ-nantes.fr |
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Abstract: | In patient with newly diagnosed multiple myeloma (MM), randomized studies have shown that autologous stem-cell transplantation (ASCT) is superior to conventional chemotherapy, and ASCT is now standard care, at least for younger patients. The best conditioning regimen is melphalan 200 mg/m2, and the best stem-cell source is unselected peripheral progenitor cells. Recent results of the IFM94 trial show that double ASCT is superior to single ASCT, at least in patients who do not achieve a 90% response after one transplant. By combining biologic markers (beta2-microglobulin, albumin) and genetic markers (hypodiploidy, chromosome 13 deletion) it is possible to accurately predict prognosis after ASCT. The results of allogeneic SCT remain disappointing due to a high transplant mortality. Strategies combining ASCT and reduced-intensity allogeneic SCT are currently being studied. |
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Keywords: | multiple myeloma autologous stem-cell transplantation allogeneic stem-cell transplantation reduced-intensity allogeneic transplantation |
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