What I wish I knew about Multiple Myeloma treatments 25 years later...

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Autologous Stem Cell Transplant- NO OVERALL SURVIVAL for Myeloma

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These results were confirmed by a meta-analysis that showed a significant benefit for HDT/ASCT in terms of EFS but no benefit in terms of OS (in myeloma)...”

The standard-of-care for newly diagnosed multiple myeloma (MM) patients who are eligible is a Hematopoietic stem cell transplant. In MM most people have an autologous stem cell transplant (ASCT). Meaning the stem cells come from you.

The Pubmed article linked and excerpted below is important for two reasons. First, the article lists ten of the most important questions to ask your oncologist before you have an ASCT. Secondly and most importantly is the fact that ASCT procedures do not increase overall survival (OS) or average length of life. ASCT can increase your event-free survival (EFS) or how long your remission lasts before relapse.

A newly diagnosed myeloma patient considering an autologous stem cell transplant must consider the advantages of a longer PFS (progression-free survival aka remission) with the probably short, long-term and late stage side effects that can accompany high-dose chemotherapy aka an autologous stem cell transplant.

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I am both a MM survivor and MM Cancer Coach. If you are considering a stem cell transplant, novel chemotherapies and/or evidence-based therapies proven to be cytotoxic to MM scroll down the page to ask a question or make a comment. Tell me your MM stage and symptoms and tell me what’s on your mind. I will reply ASAP.


David Emerson

  • Long-term MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Recommended Reading:

Treatment of autologous stem cell transplant-eligible multiple myeloma patients: ten questions and answers

“Autologous stem cell transplantation is currently considered the standard of care for multiple myeloma in young patients with adequate organ function, based on the results of trials conducted in the era prior to the advent of novel agents. While these trials demonstrated the superiority of high-dose therapy with stem cell support over conventional chemotherapy, relapse remained an issue for the majority of patients. With the introduction of the novel agents, a dramatic change in treatment strategies in the transplant setting has taken place. These agents are now incorporated prior to and following the transplant procedure, and have resulted in improvements in outcome. Importantly, improvements have also been seen in patients with high-risk cytogenetics and renal impairment. In the era of novel agents, the role of transplant itself is being questioned and trials are ongoing to establish whether transplant can be delayed until after relapse in some patients.

The current ongoing studies are aimed towards improving the different steps of the procedure with the aim of further improving efficacy and tolerability. This review addresses a number of questions surrounding the different steps of the transplant procedure and summarizes the available research evidence as a basis for decision making…


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