UPDATE ON THE ROLE OF AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION IN MULTIPLE MYELOMA

Patrizia Tosi, Manuela Imola, Mianulli Anna Maria, Simona Tomassetti, Anna Merli, Annalia Molinari, Serena Mangianti, Marina Ratta, Alessandro Isidori, Giuseppe Visani
  • Manuela Imola
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Mianulli Anna Maria
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Simona Tomassetti
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Anna Merli
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Annalia Molinari
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Serena Mangianti
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Marina Ratta
    UO Ematologia, Ospedale Infermi Rimini Italy, Italy
  • Alessandro Isidori
    Ematologia e Centro Trapianti AORMN Marche Nord Pesaro Italy, Italy
  • Giuseppe Visani
    Ematologia e Centro Trapianti AORMN Marche Nord Pesaro Italy, Italy

Abstract

Autologous stem cell transplantation is considered the standard of care for multiple myeloma patients aged < 65 years with no relevant comorbidities. The addition of drugs acting both on bone marrow microenvironment and on neoplastic plasma cells has significantly increased the proportion of patients achieving a complete remission after induction therapy, and these results are mantained after high-dose melphalan, leading to a prolonged disease control. Studies are being carried out in order to evaluate whether short term consolidation or long-term maintenance therapy can result into disease eradication at the molecular level thus increasing also patients survival. The efficacy of these new drugs has raised the issue of deferring the transplant after achivng a second response upon relapse. Another controversial point is the optimal treatment strategy for high-risk patients, that do not benefit from autologous stem cell transplantation and for whom the efficacy of new drugs is still matter of debate.

Keywords

Autologous transplantation myeloma

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Submitted: 2014-06-13 09:30:36
Published: 2012-11-05 00:00:00
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