Allograft for myeloma: Examining pieces of the Jigsaw Puzzle

Ehsan Malek, Najla El-Jurdi, Nicolaus Kröger, Marcos de Lima

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Multiple myeloma (MM) cure remains elusive despite the availability of newer anti-myeloma agents. Patients with high-risk disease often suffer from early relapse and short survival. Allogeneic hematopoietic cell transplantation (allo-HCT) is an "immune-based" therapy that has the potential to offer long-term remission in a subgroup of patients, at the expense of high rates of transplant-related morbidity and mortality. Donor lymphocyte infusion (DLI) upon disease relapse after allo-HCT is able to generate an anti-myeloma response suggestive of a graft-versus-myeloma effect. Allo-HCT provides a robust platform for additional immune-based therapy upon relapse including DLI and, maintenance with immunomodulatory drugs and immunosuppressive therapy. There have been conflicting findings from randomized prospective trials questioning the role of allo-HCT. However, to this date, allo-HCT remains the only potential curable treatment for MM and its therapeutic role needs to be better defined especially for patients with high-risk disease. This review examines different aspects of this treatment and summarizes ongoing attempts at improving its therapeutic index.

Original languageEnglish (US)
Article number287
JournalFrontiers in Oncology
Volume7
Issue numberDEC
DOIs
StatePublished - Dec 11 2017

Keywords

  • Allogeneic
  • Allograft
  • Allograft for myeloma
  • Hematopoietic stem cells
  • Multiple myeloma

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