Upfront or Deferred Autologous Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma in the Era of Triplet and Quadruplet Induction and Minimal Residual Disease/Risk-Adapted Therapy Article Swipe
Clifton C. Mo
,
Monique Hartley-Brown
,
Shonali Midha
,
Paul Richardson
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/cancers15245709
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3390/cancers15245709
The standards of care for the initial treatment of patients with newly diagnosed multiple myeloma (NDMM) who are eligible for high-dose melphalan and autologous stem cell transplantation (HDM-ASCT) include highly active triplet and quadruplet regimens based on proteasome inhibitors, immunomodulatory drugs, and monoclonal antibodies. These regimens are resulting in improved outcomes and increasingly high rates of minimal residual disease (MRD)-negative responses without HDM-ASCT as part of the upfront therapy. Furthermore, recent randomized studies have shown that, while transplant-based approaches as a frontline therapy result in significantly longer progression-free survival compared to non-transplant approaches, this has not translated into an overall survival benefit. Given these developments, and in the context of the treatment burden of undergoing HDM-ASCT, in addition to the acute toxicities and long-term sequelae of HDM, which are associated with the genotoxicity of melphalan, there is an increasing rationale for considering deferring upfront HDM-ASCT in select transplant-eligible patients and saving it as a treatment option for later salvage therapy. Here, we review the latest clinical trial data on upfront or deferred HDM-ASCT and on the activity of quadruplet induction regimens, including rates of MRD-negative responses, and summarize emerging treatment approaches in the upfront setting such as the use of MRD-directed therapy and alternatives to HDM-ASCT.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3390/cancers15245709
- https://www.mdpi.com/2072-6694/15/24/5709/pdf?version=1701768869
- OA Status
- gold
- Cited By
- 6
- References
- 84
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4389336730
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4389336730Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3390/cancers15245709Digital Object Identifier
- Title
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Upfront or Deferred Autologous Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma in the Era of Triplet and Quadruplet Induction and Minimal Residual Disease/Risk-Adapted TherapyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-12-05Full publication date if available
- Authors
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Clifton C. Mo, Monique Hartley-Brown, Shonali Midha, Paul RichardsonList of authors in order
- Landing page
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https://doi.org/10.3390/cancers15245709Publisher landing page
- PDF URL
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https://www.mdpi.com/2072-6694/15/24/5709/pdf?version=1701768869Direct link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://www.mdpi.com/2072-6694/15/24/5709/pdf?version=1701768869Direct OA link when available
- Concepts
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Medicine, Minimal residual disease, Multiple myeloma, Melphalan, Oncology, Context (archaeology), Autologous stem-cell transplantation, Transplantation, Internal medicine, Bone marrow, Biology, PaleontologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 3Per-year citation counts (last 5 years)
- References (count)
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84Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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