ASH 2021 | The future of transplantation in NDMM
Martin Kaiser, MD, FRCP, FRCPath, The Royal Marsden NHS Foundation Trust, London, UK, comments on the role of transplantation in patients with newly diagnosed multiple myeloma (NDMM). Current guidelines recommended that patients who are fit enough to withstand the intensity of transplantation should receive transplantation in the first line setting. However, Dr Kaiser notes that this is a moving field, with evidence emerging that alternative approaches may be optimal for specific subgroups in the future, such as CAR T-cell therapy. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Transcript (edited for clarity)
It is currently a moving field in terms of who we consider or don’t consider for a transplant when they’re newly diagnosed. Currently the guidelines in many European countries certainly recommend that newly diagnosed patients that are fit enough to undergo such treatment should have autologous transplant in their first line treatment. And those that are unfit should probably be considered for less intensive treatment approaches...
It is currently a moving field in terms of who we consider or don’t consider for a transplant when they’re newly diagnosed. Currently the guidelines in many European countries certainly recommend that newly diagnosed patients that are fit enough to undergo such treatment should have autologous transplant in their first line treatment. And those that are unfit should probably be considered for less intensive treatment approaches. But clearly there is more evidence emerging that potentially in some patient subgroups, such as those that have very deep responses and not as aggressive disease, there might be alternative treatment approaches in the future. And in parallel, we are also seeing, of course, new questions emerge such as CAR-T cell therapies and whether they could potentially replace, at some point, the more aggressive autologous stem cell transplant. But these are all research questions at the moment. So in our standard practice at the moment, everyone that is fit enough and that is not necessarily driven by an age driven cutoff, but really by a physician assessment, is being considered for an autologous transplant in first line treatment.
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