Dr. Hari on Misconceptions Regarding Allogeneic Stem Cell Transplant in Multiple Myeloma

Parameswaran Hari, MD, MRCP, discusses misconceptions regarding allogeneic stem cell transplant in multiple myeloma.

Parameswaran Hari, MD, MRCP, the Armand J. Quick/William F. Stapp Professor of Hematology, and the chief of the Division of Hematology/Oncology, Department of Medicine, at the Medical College of Wisconsin, discusses misconceptions regarding allogeneic stem cell transplant (allo-SCT) in multiple myeloma.

It is often thought that patients who undergo allo-SCT are more likely to develop a life-threatening infection, graft-versus-host disease (GVHD), or an immune-related complication, says Hari. However, the risk of relapse remains the biggest concern following allo-SCT.

It also believed that relapse after allo-SCT is more aggressive, says Hari. However, data has shown that patients who relapse after allo-SCT are more likely to be alive at 5 years compared with patients who relapse after an autologous stem cell transplant.

Notably, the majority of patients do not require life-long immune suppression to prevent chronic (c)GVHD after allo-SCT. Rather, about 10% of patients require immunosuppressive treatment at 10 years, and just over half of patients require treatment for cGVHD at some point following allo-SCT.

Lastly, allo-SCT was thought to be reserved for patients with high-risk multiple myeloma. While this patient population has the best risk-benefit ratio for allo-SCT, patients with standard-risk disease may also derive benefit from allo-SCT. Notably, young patients with standard-risk multiple myeloma should be considered for allo-SCT as potentially curative treatment, concludes Hari.

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