Dr. Cowan on Patient Eligibility Criteria for Transplant in Multiple Myeloma

Andrew J. Cowan, MD, an assistant professor of medicine at University of Washington School of Medicine and hematologist/oncologist at Seattle Cancer Care Alliance, discusses patient eligibility criteria for transplant in multiple myeloma.

There is no reason to be dogmatic about who is transplant-eligible and -ineligible, says Cowan; there are many factors that must be considered. For example, frailty and comorbidities are important. Age is another potential factor to consider, but older patients may be able to tolerate transplant just as well as younger patients. Although age should not be the sole determinant for transplant eligibility, most patients do develop comorbidities as they age that would, in general, limit their ability to undergo transplant, explains Cowan.

Patient preference is also important to consider. Some patients may not be interested in a transplant. Thorough discussions should be had before a decision is reached as several data sets have shown an improvement in progression-free survival with the use of a transplant by about 14 months. Although it is not a cure for multiple myeloma, transplant does confer a survival benefit.