Adults Hematology and Stem Cell Transplantation Department, King Fahad Specialist Hospital, 31444, Dammam, Kingdom of Saudi Arabia.
Curr Treat Options Oncol. 2021 Jun 10;22(8):65. doi: 10.1007/s11864-021-00864-x.
Nowadays, several novel agents have been introduced in the treatment of multiple myeloma, not only resulting in high response rates and prolonged survival but also offering good quality of life. However, the potential of cure, especially for patients with advanced or unfavorable disease features, remains elusive. Allogeneic hematopoietic stem cell transplantation, based mainly on the graft vs. myeloma effect, can offer prolonged disease control and probability of cure but unfortunately at the cost of considerable transplant-related toxicity rates. Therefore, the role of allogeneic hematopoietic stem cell transplantation in the treatment of multiple myeloma has been called into question. Recently, several studies, particularly those with long-term follow-up, demonstrated a trend of survival superiority for allografted patients with high-risk disease. These data fuel again the interest in allogeneic stem cell transplantation for selected patients with high-risk multiple myeloma, especially if the high remission rates which can be achieved with the currently used treatment protocols could be long-life sustained through the additional exploitation of the long-lasting anti-multiple myeloma effect, originating from the allograft.
如今，已有多种新型药物被引入多发性骨髓瘤的治疗中，不仅提高了缓解率和延长了生存时间，而且还提高了生活质量。然而，治愈的潜力，特别是对于晚期或预后不良的患者，仍然难以捉摸。异基因造血干细胞移植主要基于移植物抗骨髓瘤效应，可提供长期的疾病控制和治愈的可能性，但不幸的是，其代价是相当高的移植相关毒性发生率。因此，异基因造血干细胞移植在多发性骨髓瘤治疗中的作用受到了质疑。最近，一些研究，特别是那些具有长期随访的研究，表明高危疾病的异基因移植患者具有生存优势的趋势。这些数据再次激发了人们对高危多发性骨髓瘤患者进行异基因干细胞移植的兴趣，特别是如果目前使用的治疗方案可以实现高缓解率，并且通过进一步利用异基因移植产生的持久的抗多发性骨髓瘤效应，可以长期维持这种缓解率。
