Hematology Service, University Hospital La Fe, Valencia, Spain.
Curr Opin Oncol. 2012 Nov;24(6):733-41. doi: 10.1097/CCO.0b013e328358f686.
The treatment of newly diagnosed multiple myeloma has evolved rapidly over the recent years. In younger patients, autologous stem cell transplantation (ASCT) is still considered the standard of care, but the availability of new effective drugs with novel mechanisms of action in the last decade has resulted in a new scenario that has caused the role of transplantation itself to be currently undergoing scrutiny.
Maintaining the response of first-line therapy is an important objective in multiple myeloma, where despite intensive therapy followed by ASCT the majority of patients will relapse. In this field, the recent results of different consolidation and maintenance therapies after transplant are very encouraging. These strategies have come to stay and will play an essential role in the next future to improve the prognosis of young patients with newly diagnosed multiple myeloma. Finally, new conditioning regimens will also be tested in the forthcoming years in an attempt to further improve posttransplant responses.
Multiple myeloma ASCT must be integrated within a more global therapeutic approach including new and more effective induction, consolidation, and maintenance approaches. Efforts aimed in the development of more effective and less toxic preparative regimens to further augment disease control are also warranted.
近年来，新诊断多发性骨髓瘤的治疗进展迅速。在年轻患者中，自体造血干细胞移植（ASCT）仍然被认为是标准治疗方法，但在过去十年中，新型作用机制的新型有效药物的出现，导致移植本身的作用目前正在受到审查。
维持一线治疗的缓解是多发性骨髓瘤的一个重要目标，尽管接受强化治疗后进行 ASCT，但大多数患者仍会复发。在这一领域，移植后不同巩固和维持治疗的最新结果非常令人鼓舞。这些策略已经成为现实，并将在未来发挥重要作用，以改善新诊断多发性骨髓瘤年轻患者的预后。最后，新的预处理方案也将在未来几年进行测试，以试图进一步提高移植后的反应。
多发性骨髓瘤 ASCT 必须整合在更全面的治疗方法中，包括新的、更有效的诱导、巩固和维持方法。还需要努力开发更有效和毒性更低的预处理方案，以进一步增强疾病控制。
