by ecancer reporter Vanessa Lane
Allogeneic stem cell transplant (allo) in patients with multiple myeloma (MM) is a controversial treatment method.
A recent study of relapsed patients after autologous stem cell transplant (ASCT) showed that those patients treated with reduced intensity conditioning allo (RIC/allo) had better progression free survival (PFS) versus those patients who received novel therapies, but that overall survival (OS) was similar.
Upfront treatment with ASCT-RIC/allo has been more promising and has showed improvements in both PFS and OS versus ASCT alone in 2 out of 6 prospective trials. One of these studies was the EBMT-NMAM2000 study, which demonstrated significant improvements in PFS and OS for ASCT-RIC/allo versus ASCT alone at 96 months (22% vs 12% and 49% vs 36%, respectively).
Future clinical studies are needed to investigate the use of ASCT-RIC/allo in combination with novel therapies to establish whether it has a place in the upfront treatment of high risk patients and those experiencing relapse.
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