Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review

Multiple Myeloma

Mohamad Mohty  1 , Benedetto Bruno  2   3 , Nico Gagelmann  4 , Maria-Victoria Mateos  5
Anna Sureda  1 , Selim Corbacioglu  2 , Raffaella Greco  3 , Nicolaus Kröger  4 , Enric Carreras  5
, editors.
In: The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies [Internet]. 8th edition. Cham (CH): Springer; 2024. Chapter 81.
.
Affiliations
Free Books & Documents
Review

Multiple Myeloma

Mohamad Mohty et al.
Free Books & Documents

Excerpt

The concept of high-dose therapy (HDT) followed by autologous hematopoietic cell transplantation (AHCT) remains the standard for treating newly diagnosed multiple myeloma in young and in select, fit, elderly patients. The introduction of ImiDs and proteasome inhibitors administered before and/or after HDT/AHCT gave way to the groundbreaking achievement of stringent complete response (sCR), immunophenotypic CR, and molecular CR, in addition to significantly increased CR and CR plus very good partial response rate (VGPR; Table 81.1). In randomized studies, age of participants is limited to 65 years to avoid selection bias and limit toxicities and withdrawal from studies. However, this does not mean that AAHCT is not feasible in older patients. A study whereby the median age of patients was 72 years old concluded that elderly multiple myeloma patients should not be excluded from transplantation displaying good results with melphalan 140 mg/m2. Currently, in many centers, fit patients up to age 70, and even 75 years old, receive AHCT.

PubMed Disclaimer

References

    1. Cavo M, Tacchetti P, Patriarca F, Petrucci MT, Pantani L, Galli M, et al. Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma: a randomised phase 3 study. Lancet. 2010;376(9758):2075–85. - PubMed
    1. Durie BG, Hoering A, Abidi MH, Rajkumar SV, Epstein J, Kahanic SP, et al. Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial. Lancet. 2017;389(10068):519–27. - PMC - PubMed
    1. Facon T, Mary JY, Hulin C, Benboubker L, Attal M, Pegourie B, et al. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reduced-intensity autologous stem cell transplantation in elderly patients with multiple myeloma (IFM 99-06): a randomised trial. Lancet. 2007;370(9594):1209–18. - PubMed
    1. Harousseau JL, Moreau P. Autologous hematopoietic stem-cell transplantation for multiple myeloma. N Engl J Med. 2009;360(25):2645–54. - PubMed
    1. Harousseau JL, Attal M, Avet-Loiseau H, Marit G, Caillot D, Mohty M, et al. Bortezomib plus dexamethasone is superior to vincristine plus doxorubicin plus dexamethasone as induction treatment prior to autologous stem-cell transplantation in newly diagnosed multiple myeloma: results of the IFM 2005-01 phase III trial. J Clin Oncol. 2010;28(30):4621–9. - PubMed

LinkOut - more resources