The overall goal of treatment for multiple myeloma (MM) is to prolong survival for as long as possible with the minimal treatment burden for each patient. Consolidation with upfront high-dose melphalan and autologous hematopoietic stem cell transplantation (ASCT) can prolong progression-free and overall survival by deepening response. It thereby can improve quality of life by allowing patients to have a time on maintenance therapy along with infrequent office visits, making it cost-effective in many situations. The impact of minimal residual disease (MRD) negativity is important, but further studies are needed to quantify the pharmacoeconomic and quality-of-life differences between early and delayed transplant strategies. Therefore, with the currently available evidence, upfront ASCT is standard of care regardless of MRD status.
Keywords: Autologous stem cell transplant; Minimal residual disease; Multiple myeloma.
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