Stem Cell Transplantation on Multiple Myeloma

Dear Colleagues,

Despite a remarkable increase in effective treatment options, multiple myeloma (MM) still remains mostly incurable. Nevertheless, the survival of patients diagnosed with MM has significantly improved over the last few years, although outcome may be poor with a median overall survival (OS) of only 2–3 years in subgroups of patients with higher-stage and high-risk cytogenetics.

Allogeneic stem cell transplantation (alloSCT) may help to achieve long-term progression-free survival (PFS) and offers a potentially curative option due to a graft-versus-myeloma effect. However, alloSCT remains controversial because of considerable toxicity, especially due to immunosuppression and subsequent infections, the risk of graft-versus-host disease, and thus a potentially high non-relapse mortality.

In our retrospective multicenter nation-wide study in Korea, the median OS was 32.5 months, and the median PFS was 10.0 months. Survival was significantly better in patients with response to previous therapies than in those with progressive disease. Moreover, survival of patients achieving deep response after alloSCT was significantly prolonged compared to less obtaining of response. This study suggests that alloSCT in the context of novel immunotherapeutic approaches may enable long-term survival in a carefully selected subgroup with acceptable toxicity and achievement of CR after alloSCT is an important predictor of prolonged survival.

Dr. Ho-Jin Shin
Guest Editor

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