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Panminerva Medica 2020 Sep 21

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 Stem Cell Transplantation and Cellular Therapies Unit, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy; 2 Hematology Unit, Azienda Ospedaliera di Cosenza, Cosenza, Italy; 3 Scientific Directorate, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì Cesena, Italy; 4 Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì Cesena, Italy


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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; Allogeneic stem cell transplantation; Graft-Versus-Myeloma

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