SPECIAL ARTICLE  MULTIPLE MYELOMA IN 2020: STATE OF THE ART (PART I) Free access

Panminerva Medica 2020 December;62(4):234-43

DOI: 10.23736/S0031-0808.20.04142-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Allogenic stem cell transplantation in multiple myeloma: dead or alive and kicking?

Massimo MARTINO ¹, Annalisa PAVIGLIANITI ¹, Massimo GENTILE ², Giovanni MARTINELLI ³, Claudio CERCHIONE ⁴ ✉

¹ Unit of Stem Cell Transplantation and Cellular Therapies, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy; ² Unit of Hematology, Hospital of Cosenza, Cosenza, Italy; ³ IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Forlì-Cesena, Italy; ⁴ Unit of Hematology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Forlì-Cesena, Italy

Multiple myeloma (MM) accounts for about 1.8% of all cancers and slightly over 17% of hematologic malignancies. Despite improvements in outcomes in recent years, currently, there is still no cure for this disease. Although allogeneic stem cell transplantation (Allo-SCT) is a potentially curative treatment, given the armamentarium of highly effective therapeutic options and a pipeline of novel agents, many opinion leaders sustain that there is no longer a role for this approach. Of note, several studies that did not include novel agents reported long-term molecular remissions, and possibly a cure, in a subset of patients after reduced-intensity conditioning/nonmyeloablative (RIC/NM) Allo-SCT. However, there are no current data supporting upfront Allo-SCT. Prospective trials combining the so-called “graft-versus-myeloma” effect and new drugs are an unmet medical need in high-risk patients. Early relapse after first-line treatment, which identifies patients with poor prognosis independently of other prognostic factors, could become a clinical indication.

KEY WORDS: Multiple myeloma; Stem cell transplantation; Transplant