Allogeneic hematopoietic stem cell transplantation for multiple myeloma: what place, if any?

Overview

Despite the curative potential of allogeneic hematopoietic stem cell transplantation (allo HSCT) for patients with multiple myeloma (MM) and reduction of transplant-related mortality with non-myeloablative transplant approaches, the role of this treatment modality in the care of MM patients remains controversial. This controversy is due to the conflicting data emerging from the large cooperative group trials as well as the improvement in outcomes that has been seen with proteosome inhibitors, new immune modulatory drugs as well as the use of post-transplant maintenance therapy. For an individual patient, the risk benefit ratio of allografting remains uncertain. We review the current data and provide recommendations on where and how allo HSCT for myeloma should be further explored.