Brioli A. First line vs delayed transplantation in myeloma: Certainties and controversies. World J Transplant 2016; 6(2): 321-330 [PMID: 27358777 DOI: 10.5500/wjt.v6.i2.321]
Corresponding Author of This Article
Annamaria Brioli, MD, PhD, Klinik für Innere Medizin II (Abteilung Hämatologie und internistische Onkologie), Universitätsklinikum Jena, Erlanger Allee 101, 07740 Jena, Germany. annamaria.brioli2@unibo.it
Research Domain of This Article
Hematology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 24, 2016; 6(2): 321-330 Published online Jun 24, 2016. doi: 10.5500/wjt.v6.i2.321
First line vs delayed transplantation in myeloma: Certainties and controversies
Annamaria Brioli
Annamaria Brioli, Klinik für Innere Medizin II (Abteilung Hämatologie und internistische Onkologie), Universitätsklinikum Jena, 07740 Jena, Germany
Annamaria Brioli, Istituto di Ematologia Seràgnoli, Università degli Studi di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy
Author contributions: Brioli A performed bibliographical research and wrote the paper.
Conflict-of-interest statement: The author declares no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Annamaria Brioli, MD, PhD, Klinik für Innere Medizin II (Abteilung Hämatologie und internistische Onkologie), Universitätsklinikum Jena, Erlanger Allee 101, 07740 Jena, Germany. annamaria.brioli2@unibo.it
Telephone: +49-03641-9349576
Received: June 28, 2015 Peer-review started: July 5, 2015 First decision: September 17, 2015 Revised: March 22, 2016 Accepted: April 7, 2016 Article in press: April 11, 2016 Published online: June 24, 2016
Abstract
Since the middle of 1990s autologous stem cell transplantation has been the cornerstone for the treatment of young patients with multiple myeloma (MM). In the last decade the introduction of novel agents such as immunomodulatory drugs (IMiDs) and proteasome inhibitors (PI), has dramatically changed the therapeutic scenario of this yet incurable disease. Due to the impressive results achieved with IMiDs and PI both in terms of response rates and in terms of progression free and overall survival, and to the toxicity linked to high dose therapy and autologous stem cell transplantation (ASCT), a burning question nowadays is whether all young patients should be offered autotransplantation up front or if this should be reserved for the time of relapse. This article provides a review of the data available regarding ASCT in MM and of the current opinion of the scientific community regarding its optimal timing.
Core tip: Autologous stem cell transplantation (ASCT) is the cornerstone for the treatment of young multiple myeloma patients. This review summarizes the current knowledge on ASCT, with a special focus on the role of ASCT in the era of novel agents for multiple myeloma treatment.
