PMID- 22960558
OWN - NLM
STAT- MEDLINE
DCOM- 20130328
LR  - 20150212
IS  - 1531-703X (Electronic)
IS  - 1040-8746 (Linking)
VI  - 24
IP  - 6
DP  - 2012 Nov
TI  - Allogeneic hematopoietic stem cell transplantation for multiple myeloma: curative 
      but not the standard of care.
PG  - 720-6
LID - 10.1097/CCO.0b013e328358f619 [doi]
AB  - PURPOSE OF REVIEW: Despite the curative potential of allogeneic hematopoietic 
      stem cell transplantation (allo HSCT) for patients with multiple myeloma, and 
      reduction of transplant-related mortality with nonmyeloablative transplant 
      approaches, rates of acute and chronic graft-versus-host disease and disease 
      progression remain high. It is unclear if nonmyeloablative transplants are more 
      effective than autologous (auto). Novel promising drugs and maintenance treatment 
      strategies following auto SCT may also delay allo transplantation. In this 
      review, we summarize the emerging data on allo HSCT and provide suggestions for 
      its optimal role in the treatment of myeloma. RECENT FINDINGS: Large cooperative 
      group studies comparing allo HSCT with auto SCT as frontline therapy have been 
      performed with reduced intensity conditioning regimens using unmanipulated 
      peripheral blood stem cells from human leukocyte antigen (HLA)-compatible donors 
      and standard calcineurin inhibitor graft-versus-host disease prophylaxis. Two 
      recent reports show conflicting data. Although the Blood and Marrow Transplant 
      Clinical Trials Network 0102 study demonstrated no progression-free or overall 
      survival advantage at 3 years, a European study demonstrated superior 5-year 
      outcome after auto/HLA-matched sibling allo HSCT compared with tandem auto SCT in 
      previously untreated multiple myeloma patients. The advent of maintenance therapy 
      could potentially improve outcomes of both transplant types. SUMMARY: High rates 
      of acute and chronic graft-versus-host disease currently limit the implementation 
      of nonmyeloablative allo HSCT. Novel approaches are required so that patients 
      with myeloma can undergo allo HSCT before resistance develops to standard drug 
      combinations.
FAU - Koehne, Guenther
AU  - Koehne G
AD  - Adult Bone Marrow Transplantation Service, Division of Hematologic Oncology, 
      Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell 
      Medical College, New York, New York 10065, USA. koehneg@mskcc.org
FAU - Giralt, Sergio
AU  - Giralt S
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Oncol
JT  - Current opinion in oncology
JID - 9007265
RN  - 0 (Myeloablative Agonists)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Graft vs Host Disease/prevention & control
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - Humans
MH  - Immunotherapy
MH  - Melphalan/therapeutic use
MH  - Multiple Myeloma/*therapy
MH  - Myeloablative Agonists/therapeutic use
MH  - Risk
MH  - *Standard of Care
MH  - Transplantation, Homologous
MH  - Treatment Outcome
EDAT- 2012/09/11 06:00
MHDA- 2013/03/30 06:00
CRDT- 2012/09/11 06:00
PHST- 2012/09/11 06:00 [entrez]
PHST- 2012/09/11 06:00 [pubmed]
PHST- 2013/03/30 06:00 [medline]
AID - 10.1097/CCO.0b013e328358f619 [doi]
PST - ppublish
SO  - Curr Opin Oncol. 2012 Nov;24(6):720-6. doi: 10.1097/CCO.0b013e328358f619.