Autologous Stem Cell Transplantation for Multiple Myeloma in the Era of Novel Medicines

The overall survival(OS) in patients with multiple myeloma (MM) has been prolonged from 3 years to 8-10 years during the past 20 years, which benefits from the broad use of novel agents including proteasome inhibitors and immune modulatory drugs. Even in the era of novel medicines, high-dose melphalan followed by autologous stem cell transplantation (ASCT) is the standard treatment for transplant candidates of newly diagnosed MM. ASCT significantly further improves the post-transplant response rate and the proportion of negative minimal residual disease, as well as leading to better progression-free survival. Nevertheless, the effect of ASCT on OS was not consistent among different clinical trials, which was probably related to different strategies after relapse. As other novel methods including monoclonal antibodies and immune therapies are being developed, more alternatives will be considered. Therefore, ASCT is still the front-line consolidation regimen for transplant candidates with MM.