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COMy 2025 | The evolving role of transplantation in Waldenström’s and which patients may benefit from it
Steven Treon, MD, PhD, FRCP, Dana-Farber Cancer Institute, Boston, MA, reflects on the evolving role of autologous stem cell transplantation (autoSCT) in the treatment of Waldenström’s macroglobulinemia (WM) in light of the effectiveness of novel agents such as BTK and BCL2 inhibitors. Dr Treon highlights that autoSCT is becoming increasingly infrequent and is now only considered in specific circumstances, such as consolidation therapy for patients with amyloid. This interview took place at the 11th World Congress on Controversies in Multiple Myeloma (COMy) congress in Paris, France.
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Transcript
I am so happy people are still asking about transplantation because the answer continues to be that patients are doing so well with the current chemo-immunotherapy options, BTK inhibitors, BCL2 inhibitors also, we’re going to be seeing an expansion of our options around BCL2, that transplantation is taking less and less of a role in the management of Waldenstrom’s...
I am so happy people are still asking about transplantation because the answer continues to be that patients are doing so well with the current chemo-immunotherapy options, BTK inhibitors, BCL2 inhibitors also, we’re going to be seeing an expansion of our options around BCL2, that transplantation is taking less and less of a role in the management of Waldenstrom’s. In fact, it’s so infrequent. But I do want to remind our colleagues, there are circumstances where one should be thinking about autologous transplant. What are those circumstances? Well, predominantly patients with amyloid because we still see that consolidation with autologous transplant represents a very important option for consolidating therapy. We typically tend to use proteasome inhibitors as sort of our induction agents, sometimes bendamustine, although we keep in mind the impact of stem cell collection with bendamustine. That may be the only circumstance that today we routinely consider and use autologous stem cell transplant. Otherwise, look, times are good and the fact that we’ve been able to evolve beyond autologous transplant is important. The last thing I want to share with my colleagues is this is the era of cellular immunotherapies. This is what our field really needs and this is what we’re focusing on these days.
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