[Updated treatment strategy for transplant-eligible multiple myeloma: current status and future perspectives]

Rinsho Ketsueki. 2023;64(9):1066-1073. doi: 10.11406/rinketsu.64.1066.
[Article in Japanese]

Abstract

Treatment outcomes of multiple myeloma (MM) have dramatically improved in the past 20 years. The IFM/DFCI group reported that triplet induction (bortezomib, lenalidomide, and dexamethasone), followed by up-front high-dose melphalan and autologous stem cell transplantation (HDM/ASCT) and maintenance therapy, demonstrated a median progression-free survival (PFS) of 50 months. Therefore, up-front HDM/ASCT is considered standard care even in the era of novel agents. Daratumumab, lenalidomide, and dexamethasone have also been reported to prolong PFS for newly diagnosed transplant-ineligible MM. Quadruplet induction, including anti-CD38 antibody, will be approved even for transplant-eligible MM soon. Conversely, the success of chimeric antigen receptor T-cell therapy revealed that cellular immunotherapy may play an important role in treating MM. This review discussed the current standard of care and future perspectives for transplant-eligible MM.

Keywords: HDM/ASCT BCMA; Multiple myeloma.

Publication types

  • Review
  • English Abstract

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Dexamethasone / therapeutic use
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lenalidomide / therapeutic use
  • Melphalan / therapeutic use
  • Multiple Myeloma* / drug therapy
  • Transplantation, Autologous

Substances

  • Lenalidomide
  • Melphalan
  • Dexamethasone