Management of relapsed multiple myeloma after autologous stem cell transplant

Biol Blood Marrow Transplant. 2015 May;21(5):793-8. doi: 10.1016/j.bbmt.2014.12.026. Epub 2015 Jan 31.

Abstract

Autologous stem cell transplantation (ASCT) remains a standard of care for multiple myeloma patients who are eligible to receive high-dose therapy, recognizing that the optimal timing and integration of this approach is now under study in a number of randomized trials. Despite the improved response rates with induction therapy consisting of immunomodulatory drugs and/or proteasome inhibitors, as well as the increasing use of post-ASCT maintenance therapy, most myeloma patients relapse and die of their disease. Here we discuss the options for managing post-ASCT relapse, including the role of various salvage regimens in the setting of relapsed and refractory myeloma, salvage ASCT, and salvage allogeneic SCT.

Keywords: Monoclonal antibody; Multiple myeloma salvage autologous stem cell transplant; Relapsed/refractory; Salvage allogenic stem cell transplant.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Autografts
  • Dexamethasone / administration & dosage*
  • Humans
  • Immunologic Factors / administration & dosage*
  • Lenalidomide
  • Male
  • Middle Aged
  • Multiple Myeloma / therapy*
  • Proteasome Inhibitors / administration & dosage*
  • Recurrence
  • Stem Cell Transplantation*
  • Thalidomide / administration & dosage
  • Thalidomide / analogs & derivatives*

Substances

  • Immunologic Factors
  • Proteasome Inhibitors
  • Thalidomide
  • Dexamethasone
  • Lenalidomide