Multiple Myeloma
Approximately 30,000 individuals are diagnosed with multiple myeloma in the United States each year, with a median age at diagnosis of 69 years. [1]
Multiple myeloma is the most common indication for hematopoietic cell transplantation (HCT) in the United States. Approximately 96% of transplants in patients with multiple myeloma are autologous transplants, according to the Center for International Blood and Marrow Transplant Research® (CIBMTR®), our research program. [2]
Initial treatment for patients with multiple myeloma is typically a course of induction therapy, followed by autologous HCT in eligible patients. Allogeneic transplantation for multiple myeloma is generally reserved for patients with high-risk disease and the majority performed after an autologous HCT with reduced-intensity or non-myeloablative conditioning regimens. [2,3]
Advances
Recent research in multiple myeloma provides new data for clinical decision-making and treatment advances in this older patient population, including:
- Using reduced-intensity conditioning allogeneic HCT [4]
- Exploring the benefit of tandem auto/auto or auto/allo transplants - autologous HCT followed by either a second autologous HCT or a reduced-intensity allogeneic HCT [4,5,6]
- Using IMID-class drugs such as thalidomide and lenalidomide, proteasome inhibitors such as bortezomib and carfilzomib, and other novel drugs as part of initial or subsequent treatment or as maintenance therapy following HCT [3]
Outcomes
Review outcomes for autologous and allogeneic transplantation in patients with multiple myeloma below. View additional multiple myeloma slides showing demographic data and transplant trends.
Data in this section have been prepared by CIBMTR.
Figure 1: Multiple Myeloma Survival, HCT, by Donor Type
Download slide "Multiple Myeloma Survival, HCT, by Donor Type"
Referral Timing Guidelines
These guidelines highlight disease categories that include patients at risk for disease progression and who should be referred for a consultation for autologous or allogeneic transplantation. [7]
Transplant Consultation Guidelines: Multiple Myeloma
- At diagnosis
- At first progression
Download as a slide (PPT)
View complete Referral Timing Guidelines
References
- SEER Stat Fact Sheets: Myeloma. Accessed 9 March, 2018. Access
- D'Souza A, Fretham C. Current Uses and Outcomes of Hematopoietic Cell Transplantation (HCT): CIBMTR Summary Slides, 2017. Available at: http://www.cibmtr.org
- Kyle RA, Rajkumar SV. Multiple myeloma. Blood. 2008; 111(6): 2962-2972. Access
- Bensinger WI. Role of autologous and allogeneic stem cell transplantation in myeloma. Leukemia. 2009; 23(3): 442-448. Access
- Krishnan A, Pasquini MC, Logan B, et al. Autologous haemopoietic stem-cell transplantation followed by allogeneic or autologous haemopoietic stem-cell transplantation in patients with multiple myeloma (BMT CTN 0102): A phase 3 biological assignment trial. Lancet Oncol. 2011; 12(13): 1195-1203. Access
- Gahrton G, Iacobelli S, Björkstrand B, et al. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: Long-term results of the EBMT-NMAM2000 study. Blood. 2013; 121(25): 5055-5063. Access
- NMDP/Be The Match and ASBMT Recommended Timing for Transplant Consultation, 2018. Download (PDF)