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Hematopoietic stem cell transplantation for the treatment of multiple myeloma

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Author:
No author available
Journal Title:
JOURNAL OF LEUKEMIA & LYMPHOMA
Issue:
9
DOI:
10.3760/cma.j.issn.1009-9921.2010.09.002
Key Word:
多发性骨髓瘤;造血干细胞移植;治疗;Multiple myeloma;Hematopoietic stem cell transplantation;Therapy

Abstract: Autologous stem cell transplantation(ASCT) significantly increased the complete response rate(CR) and long-term survival in the patients younger than 65 years with multiple myeloma(MM). ASCT in the early stage of disease is currently considered the standard therapy in younger patients with newly diagnosed MM. High-dose melphalan with 200 mg/m2 is still considered the best conditioning. Double autotransplant is recommended for the patients without having VGPR after the first ASCT. Novel pretransplant induction regimens and conditioning with novel drugs such as bortezomib could improve the effect of ASCT. The best curative approach in multiple myeloma is allogeneic transplantation (allo-HSCT) with much higher CR. The long-term survival of patients receiving conventional/myeloablative conditioning (MAC) allo-HSCT is not better than that of the ASCT because of higher transplant-related mortility (TRM). Allo-HSCT with MAC has almost universally been replaced by the dose-reduced intensity conditioning allogeneic transplantation (Allo-RIC),which has lower TRM. More patients and long-term follow-up are needed to test the efficacy of single ASCT followed by Allo-RIC in patients with multiple myeloma.

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