Treatment of newly diagnosed multiple myeloma: early autologous stem cell transplantation versus novel agents
Schweden, A.M.C., supervised by Nijhof, I., Department of hematology VUmc
Background: Multiple myeloma is still incurable, nevertheless, the field of treatment has made major advances in the past two decades. Compared to conventional chemotherapy the best results are yet to be achieved with high dose melphalan and autologous stem cell transplantation (HDM-ASCT). However, HDM-ASCT causes much treatment-related problems, such as toxicity and hospitalization. The past years novel agents have been developed, with a better tolerability and no mandatory hospitalization. Those novel agents have been compared to HDM-ASCT in a few trials in terms of progression-free survival and overall survival, although, there has not been a systematic review since the most recent study publications.
Objective: To analyze whether the HDM-ASCT procedure is superior to novel agents, as first-line treatment of multiple myeloma in transplant-eligible patients £65 years.
Methods: A literature search was performed in PubMed and Embase, based on MeSH and TiAb terms of: “multiple myeloma”, “autologous stem cell transplantation”, “conventional chemotherapy”, “novel agents”, “progression-free survival” and “overall survival”.
Results: The search strategy provided five prospective articles and four retrospective articles, which included 1698 patients in the HDM-ASCT group and 1685 patients in the novel agent group, respectively.
The mean complete response (CR) is statistically significantly improved in HDM-ASCT, 42.62% vs 33.28%, P