Dr. Martin on Autologous Stem Cell Transplant in Multiple Myeloma

Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, and associate director, Myeloma Program, University of California, San Francisco; co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center, discusses autologous stem cell transplant (ASCT) in multiple myeloma.

Though ASCT is commonly used as a frontline treatment for patients with newly diagnosed multiple myeloma, there are some limitations, says Martin. Patients older than age 75 are rarely transplant candidates. Additionally, patients who have ongoing pulmonary comorbidities or cardiac issues are often ineligible for transplant.

Most patients younger than 70 are eligible candidates, and most patients can tolerate it. Many randomized trials have been done to see how frontline transplant compares with standard triplet therapy, notes Martin. Essentially, every trial has shown that patients do better in terms of progression-free survival and depth of remission if they undergo ASCT. People who have relapsed disease typically do not receive ASCT, says Martin, which is why he recommends frontline transplant.