Dr. Kröger on Toxicities Associated With Allogeneic Stem Cell Transplant in Myeloma

Nicolaus Kröger, MD, a professor and medical director of the Department of Stem Cell Transplantation at the University Hospital Hamburg-Eppendorf, in Hamburg, Germany, discusses toxicities associated with allogeneic stem cell transplant in patients with multiple myeloma.

Allogeneic stem cell transplantation is an immunotherapy that has been working efficiently in patients with multiple myeloma, according to Kröger. The efficacy of immunotherapy has been observed with novel therapies, such as new antibody treatments, CAR T-cell therapies, and stem cell transplantation wherein donor T cells are the major effector that can elicit a graft-versus-myeloma effect. This effect can help to deepen remission and induce a higher rate of complete remission, regardless of whether a risk of relapse still exists, Kröger says.

However, the T cells do not specifically target myeloma cells, and will also target other cells in the patient and induce graft-versus host disease (GVHD). New options have emerged to help treat or prevent GVHD; however, it is important to be careful, as GVHD prevention can result in a lower graft-versus-myeloma effect. This translates to a higher risk of relapse, Kröger concludes.