Transplant-Eligible NDMM: Quad-Based Induction, Transplant Timing, and Selective Consolidation

This segment transitions to patients with transplant-eligible (transplant-intended) newly diagnosed multiple myeloma (NDMM) and explores how quad-based induction regimens are being incorporated into clinical practice. Faculty discuss typical frontline strategies for fit patients, including the use of quad regimens and practical considerations such as the optimal number of induction cycles before autologous stem cell transplant, which commonly ranges from three to four cycles.

The panel also examines the role of post-transplant consolidation and how clinicians individualize this decision based on disease biology and response to therapy. While many standard-risk patients may proceed directly to maintenance, consolidation may be considered in selected higher-risk scenarios such as aggressive cytogenetic features, plasma cell leukemia, or extramedullary disease in order to deepen responses and achieve MRD negativity.

Real-world factors that influence treatment selection are also discussed, including patient travel distance, work obligations, and the feasibility of intensive clinic schedules. Overall, the segment highlights practical approaches to sequencing quad-based induction, transplant, consolidation in selected patients, and maintenance therapy in contemporary transplant-eligible NDMM management.