Martin Kaiser, MD, from the Institute of Cancer Research, London, UK, discusses the challenges of allogeneic stem cell transplant in myeloma at the 2017 British Society for Haematology (BSH) Annual Scientific Meeting in Brighton, UK. He describes the main challenges of high toxicity and risk of relapse, and points out that transplants are only considered for young and reasonably fit patients, which excludes the majority of the myeloma patient population. Dr Kaiser outlines discussions on which patients benefit from allogeneic stem cell transplants in myeloma, taking into consideration genetic factors and risk group. He concludes that decisions about a transplant should be driven by the patient.