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Blood Cancers Video Library: Multiple Myeloma – Should everyone receive an autologous transplant?

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GRACE joined a number of top faculty in the area of hematology in Whistler BC, for the 3rd Annual Summit on Hematologic Malignancies.  William Bensinger, MD, PhD, with the Myeloma and Transplant Program at Swedish Cancer Institute in Seattle, talks with GRACE about stem cell transplantation, and the data showing that among transplant-eligible patients autologous stem cell transplant improves the response rate, improves progression free and in most but not all studies, overall survival.

 

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Multiple Myeloma – Should everyone receive an autologous transplant?

William Bensinger, MD, PhD
Myeloma and Transplant Program
Swedish Cancer Institute in Seattle, Washington

 

I’m going to talk about stem cell transplantation. There is abundant data showing that among transplant-eligible patients autologous stem cell transplant improves the response rate, improves progression free and in most but not all studies, overall survival. These studies were done primarily in patients up to age 65 or 70. I think you can say for patients who are of the appropriate age and don’t have any comorbid conditions that might prevent a transplant or make transplant more hazardous, that a stem cell transplant should be considered as part of the therapy.

For older patients, patients over the age of 75, I think there’s less data on the benefits of transplant. There are only one or two studies in such patients, and generally they do not show significant benefit for the transplant group, compared to studies that compare continuous therapy with maintenance. As such, I think you have to be more cautious about recommending transplant in the older age group, mainly because we just don’t have as much data supporting its benefits for that group of patients. 


 

 

 


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