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Prashant Kapoor, MD, FACP


SOHO 2022: Exploring the Role of Salvage Autologous HCT in Myeloma

By: Kayci Reyer
Posted: Friday, October 21, 2022

According to research presented at the 2022 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract EXABS-129-CT), salvage autologous hematopoietic cell transplantation (HCT) is recommended for some patients with multiple myeloma. Second transplantation is associated with a durable response and prolonged survival during relapse, especially among patients not receiving maintenance therapy, although the procedure is not commonly used in the United States.

“Salvage [autologous] HCT is also appealing in regions with limited or no availability of novel anti–multiple myeloma agents,” noted Luciano J. Costa, MD, PhD, of the University of Alabama at Birmingham. “Efforts are needed to refine the conditioning regimen and post salvage [autologous] HCT maintenance therapy in order to make it more helpful and better define its role in modern [multiple myeloma] care.”

Subsequent transplantation has been demonstrated to result in longer progression-free and overall survival among patients who were largely bortezomib- and lenalidomide-naive. Among another set of patients, most of whom had previously received lenalidomide and/or bortezomib treatment, survival outcomes were comparable between those who experienced salvage transplantation and those who did not, commented Dr. Costa. The overall data landscape indicates that salvage transplantation becomes a less-effective disease control measure as upfront therapy increases in efficacy. Salvage transplantation has previously been combined with other therapies, such as gemcitabine or a proteasome inhibitor, to a tolerable but ultimately no more effective end, he continued. However, salvage transplantation is encouraged, particularly for patients who chose not to receive a transplant during initial treatment. It is recommended that patients who are eligible should have enough stem cells collected to make salvage transplantation an option.

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