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Hematologic Malignancies • Medical Oncology • Internal Medicine • Hematology • Journal Club ft. NEJM publications • Multiple Myeloma
Are you still recommending autologous stem cell transplantation (ASCT) for all eligible myeloma patients who achieve remission after induction with a quadruplet regimen?
Or can we omit it in older patients given efficacy of these regimens? Is transplant-eligibility still an important distinction up front given options for anti-CD38 regimens regardless?
Answer from: Medical Oncologist at Academic Institution
No. ASCT is a discussion process with the patients. The GRIFFIN and PERSEUS trials used Dara throughout induction, consolidation, and maintenance. The MRD- status deepened over the course of the treatment. The IFM-09 and DETERMINATION trials showed similar OS for patients with upfront vs delayed ASC...
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Answer from: Medical Oncologist at Academic Institution
Our institution still recommends upfront autologous transplant for most fit patients. We appreciate the recent results from CEPHEUS and BENEFIT, but if we believe that achieving MRD negativity is important, the addition of autologous transplant improves the rate of MRD negativity, which ultimately s...