{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:46:08Z","timestamp":1788885968272,"version":"build-2803163510"},"reference-count":50,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>High-dose melphalan supported by autologous transplantation has been the standard of care for eligible patients with newly diagnosed multiple myeloma for nearly 30 years. Several randomized clinical trials have reaffirmed the strong position of transplant in the era of triplets combining proteasome inhibitors, immunomodulatory drugs, and dexamethasone. Although quadruplets are becoming the standard in transplantation programs, no data are currently available on the need for a transplant with new regimens incorporating anti-CD38 monoclonal antibodies. Outcomes remain heterogeneous, with different response depths and durations depending on the cytogenetics at diagnosis. The improvement of disease prognostication using sensitive and specific tools allows for adapting the strategy to initial and dynamic risks. This review examines which patients need a transplant, when transplantation is preferable, and why.<\/jats:p>","DOI":"10.1182\/hematology.2024000580","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T15:05:24Z","timestamp":1733497524000},"page":"561-568","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":7,"title":["Transplant in myeloma: who, when, and why?"],"prefix":"10.1182","volume":"2024","author":[{"given":"Aurore","family":"Perrot","sequence":"first","affiliation":[{"name":"Hematology Department, Toulouse University Hospital, Institut Universitaire du Cancer de Toulouse-Oncopole CHU Toulouse, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2024,12,6]]},"reference":[{"issue":"1","key":"2024121115465012300_hem2024000580C1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"2024121115465012300_hem2024000580C2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S1470-2045(14)70282-7","article-title":"Survival for haematological malignancies in Europe between 1997 and 2008 by region and age: results of EUROCARE-5, a population-based study","volume":"15","author":"Sant","year":"2014","journal-title":"Lancet Oncol"},{"issue":"2","key":"2024121115465012300_hem2024000580C3","first-page":"e528","article-title":"Multiple myeloma: EHA-ESMO clinical practice guidelines for diagnosis, treatment and follow up","volume":"5","author":"Dimopoulos","year":"2021","journal-title":"Hemasphere"},{"issue":"5","key":"2024121115465012300_hem2024000580C4","first-page":"619","article-title":"[Prolonged survival in a case of multiple myeloma treated with high dose of melphalan]","volume":"14","author":"Shibata","year":"1973","journal-title":"Rinsho Ketsueki"},{"issue":"8354","key":"2024121115465012300_hem2024000580C5","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0140-6736(83)90739-0","article-title":"High-dose intravenous melphalan for plasma-cell leukaemia and myeloma","volume":"2","author":"McElwain","year":"1983","journal-title":"Lancet"},{"issue":"5","key":"2024121115465012300_hem2024000580C6","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1182\/blood.V79.5.1130.1130","article-title":"Intensive combined therapy for previously untreated aggressive myeloma","volume":"79","author":"Attal","year":"1992","journal-title":"Blood"},{"issue":"7","key":"2024121115465012300_hem2024000580C7","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1182\/blood.V82.7.2005.2005","article-title":"High-dose chemoradiotherapy and autologous blood stem cell transplantation in multiple myeloma: results of a phase II trial involving 63 patients","volume":"82","author":"Fermand","year":"1993","journal-title":"Blood"},{"issue":"4","key":"2024121115465012300_hem2024000580C8","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1200\/JCO.1994.12.4.759","article-title":"High-dose melphalan and autologous bone marrow transplantation as consolidation in previously untreated myeloma","volume":"12","author":"Cunningham","year":"1994","journal-title":"J Clin Oncol"},{"issue":"1","key":"2024121115465012300_hem2024000580C9","first-page":"7","article-title":"Impact on survival of high-dose therapy with autologous stem cell support in patients younger than 60 years with newly diagnosed multiple myeloma: a population-based study. Nordic Myeloma Study Group","volume":"95","author":"Lenhoff","year":"2000","journal-title":"Blood"},{"issue":"2","key":"2024121115465012300_hem2024000580C10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1056\/NEJM199607113350204","article-title":"A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Fran\u00e7ais du My\u00e9lome","volume":"335","author":"Attal","year":"1996","journal-title":"N Engl J Med"},{"issue":"9","key":"2024121115465012300_hem2024000580C11","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1182\/blood.V92.9.3131","article-title":"High-dose therapy and autologous peripheral blood stem cell transplantation in multiple myeloma: up-front or rescue treatment? Results of a multicenter sequential randomized clinical trial","volume":"92","author":"Fermand","year":"1998","journal-title":"Blood"},{"issue":"19","key":"2024121115465012300_hem2024000580C12","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1056\/NEJMoa022340","article-title":"High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma","volume":"348","author":"Child","year":"2003","journal-title":"N Engl J Med"},{"issue":"10","key":"2024121115465012300_hem2024000580C13","doi-asserted-by":"crossref","first-page":"3052","DOI":"10.1182\/blood-2004-02-0408","article-title":"Intermediate-dose melphalan improves survival of myeloma patients aged 50 to 70: results of a randomized controlled trial","volume":"104","author":"Palumbo","year":"2004","journal-title":"Blood"},{"issue":"36","key":"2024121115465012300_hem2024000580C14","doi-asserted-by":"crossref","first-page":"9227","DOI":"10.1200\/JCO.2005.03.0551","article-title":"High-dose therapy and autologous blood stem-cell transplantation compared with conventional treatment in myeloma patients aged 55 to 65 years: long-term results of a randomized control trial from the Group Myelome-Autogreffe","volume":"23","author":"Fermand","year":"2005","journal-title":"J Clin Oncol"},{"issue":"12","key":"2024121115465012300_hem2024000580C15","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1182\/blood-2005-03-1301","article-title":"High-dose therapy intensification compared with continued standard chemotherapy in multiple myeloma patients responding to the initial chemotherapy: long-term results from a prospective randomized trial from the Spanish cooperative group PETHEMA","volume":"106","author":"Blad\u00e9","year":"2005","journal-title":"Blood"},{"issue":"6","key":"2024121115465012300_hem2024000580C16","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1200\/JCO.2005.04.5807","article-title":"Standard chemotherapy compared with high-dose chemoradiotherapy for multiple myeloma: final results of phase III US Intergroup Trial S9321","volume":"24","author":"Barlogie","year":"2006","journal-title":"J Clin Oncol"},{"issue":"14","key":"2024121115465012300_hem2024000580C17","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","article-title":"Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma","volume":"376","author":"Attal","year":"2017","journal-title":"N Engl J Med"},{"issue":"suppl 1","key":"2024121115465012300_hem2024000580C18","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1182\/blood-2020-134538","article-title":"Early versus late autologous stem cell transplant in newly diagnosed multiple myeloma: long-term follow-up analysis of the IFM 2009 trial","volume":"136","author":"Perrot","year":"2020","journal-title":"Blood"},{"issue":"2","key":"2024121115465012300_hem2024000580C19","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1056\/NEJMoa2204925","article-title":"Triplet therapy, transplantation, and maintenance until progression in myeloma","volume":"387","author":"Richardson","year":"2022","journal-title":"N Engl J Med"},{"issue":"6","key":"2024121115465012300_hem2024000580C20","doi-asserted-by":"crossref","first-page":"e456","DOI":"10.1016\/S2352-3026(20)30099-5","article-title":"Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly-diagnosed multiple myeloma (EMN02\/HO95): a multicentre, randomised, open-label, phase 3 study","volume":"7","author":"Cavo","year":"2020","journal-title":"Lancet Haematol"},{"issue":"12","key":"2024121115465012300_hem2024000580C21","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/S1470-2045(21)00535-0","article-title":"Carfilzomib with cyclophosphamide and dexamethasone or lenalidomide and dexamethasone plus autologous transplant or carfilzomib plus lenalidomide and dexamethasone followed by maintenance with carfilzomib plus lenalidomide or lenalidomide alone for patients with newly diagnosed multiple myeloma (FORTE): a randomised, open-label, phase 2 trial","volume":"22","author":"Gay","year":"2021","journal-title":"Lancet Oncol"},{"key":"2024121115465012300_hem2024000580C22","article-title":"Efficacy and safety of Isa-KRD induction before response-adapted consolidation in transplant eligible newly diagnosed multiple myeloma: an interim analysis of the IFM2020-02 MIDAS study","author":"Perrot","year":"24","journal-title":"Clin Lymphoma Myeloma Leuk"},{"issue":"suppl","key":"2024121115465012300_hem2024000580C23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/01.HS9.0000936220.68605.8b","article-title":"EMAGINE\/CARTITUDE-6: a randomized phase 3 study of DVRD followed by ciltacabtagene autoleucel versus DVRD followed by autologous stem cell transplant in transplant-eligible patients with newly diagnosed multiple myeloma","volume":"7","author":"Broijl","year":"2023","journal-title":"Hemasphere"},{"issue":"3","key":"2024121115465012300_hem2024000580C24","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1182\/blood.V99.3.731","article-title":"Comparison of 200\u2009mg\/m(2) melphalan and 8Gy total body irradiation plus 140\u2009mg\/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the Intergroupe Francophone du My\u00e9lome 9502 randomized trial","volume":"99","author":"Moreau","year":"2002","journal-title":"Blood"},{"issue":"3","key":"2024121115465012300_hem2024000580C25","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1046\/j.1365-2141.2000.02093.x","article-title":"A combination of anti-interleukin 6 murine monoclonal antibody with dexamethasone and high-dose melphalan induces high complete response rates in advanced multiple myeloma","volume":"109","author":"Moreau","year":"2000","journal-title":"Br J Haematol"},{"issue":"1","key":"2024121115465012300_hem2024000580C26","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/bmt.2015.211","article-title":"A randomized study of melphalan 200\u2009\u200amg\/m(2) vs 280\u2009\u200amg\/m(2) as a preparative regimen for patients with multiple myeloma undergoing auto-SCT","volume":"51","author":"Bensinger","year":"2016","journal-title":"Bone Marrow Transplant"},{"issue":"4","key":"2024121115465012300_hem2024000580C27","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1111\/j.1365-2141.2005.05641.x","article-title":"High-dose idarubicin, cyclophosphamide and melphalan as conditioning for autologous stem cell transplantation increases treatment-related mortality in patients with multiple myeloma: results of a randomised study","volume":"130","author":"Fenk","year":"2005","journal-title":"Br J Haematol"},{"issue":"5","key":"2024121115465012300_hem2024000580C28","doi-asserted-by":"crossref","first-page":"e266","DOI":"10.1016\/S2352-3026(19)30023-7","article-title":"Conditioning with busulfan plus melphalan versus melphalan alone before autologous haemopoietic cell transplantation for multiple myeloma: an open-label, randomised, phase 3 trial","volume":"6","author":"Bashir","year":"2019","journal-title":"Lancet Haematol"},{"issue":"18","key":"2024121115465012300_hem2024000580C29","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1182\/blood.2021014635","article-title":"Bortezomib and high-dose melphalan conditioning regimen in frontline multiple myeloma: an IFM randomized phase 3 study","volume":"139","author":"Roussel","year":"2022","journal-title":"Blood"},{"issue":"4","key":"2024121115465012300_hem2024000580C30","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1002\/hon.2767","article-title":"Exploratory analysis of intensified conditioning as first line treatment for patients with high risk multiple myeloma","volume":"38","author":"Bommier","year":"2020","journal-title":"Hematol Oncol"},{"issue":"26","key":"2024121115465012300_hem2024000580C31","doi-asserted-by":"crossref","first-page":"2495","DOI":"10.1056\/NEJMoa032290","article-title":"Single versus double autologous stem-cell transplantation for multiple myeloma","volume":"349","author":"Attal","year":"2003","journal-title":"N Engl J Med"},{"issue":"17","key":"2024121115465012300_hem2024000580C32","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1200\/JCO.2006.10.2509","article-title":"Prospective, randomized study of single compared with double autologous stem-cell transplantation for multiple myeloma: Bologna 96 clinical study","volume":"25","author":"Cavo","year":"2007","journal-title":"J Clin Oncol"},{"issue":"5","key":"2024121115465012300_hem2024000580C33","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1111\/bjh.13994","article-title":"Single versus tandem high-dose melphalan followed by autologous blood stem cell transplantation in multiple myeloma: long-term results from the phase III GMMG-HD2 trial","volume":"173","author":"Mai","year":"2016","journal-title":"Br J Haematol"},{"issue":"7","key":"2024121115465012300_hem2024000580C34","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1200\/JCO.18.00685","article-title":"Autologous transplantation, consolidation, and maintenance therapy in multiple myeloma: results of the BMT CTN 0702 trial","volume":"37","author":"Stadtmauer","year":"2019","journal-title":"J Clin Oncol"},{"issue":"1","key":"2024121115465012300_hem2024000580C35","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1200\/JCO.23.01696","article-title":"Isatuximab, carfilzomib, lenalidomide, and dexamethasone for the treatment of high-risk newly diagnosed multiple myeloma","volume":"42","author":"Leypoldt","year":"2024","journal-title":"J Clin Oncol"},{"issue":"20","key":"2024121115465012300_hem2024000580C36","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1182\/blood.2023023597","article-title":"Daratumumab, carfilzomib, lenalidomide, and dexamethasone with tandem transplant for high-risk newly diagnosed myeloma","volume":"143","author":"Touzeau","year":"2024","journal-title":"Blood"},{"issue":"8","key":"2024121115465012300_hem2024000580C37","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/S1470-2045(24)00282-1","article-title":"Bortezomib, thalidomide, and dexamethasone with or without daratumumab and followed by daratumumab maintenance or observation in transplant-eligible newly diagnosed multiple myeloma: long-term follow-up of the CASSIOPEIA randomised controlled phase 3 trial","volume":"25","author":"Moreau","year":"2024","journal-title":"Lancet Oncol"},{"issue":"10","key":"2024121115465012300_hem2024000580C38","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1016\/S2352-3026(23)00217-X","article-title":"Addition of daratumumab to lenalidomide, bortezomib, and dexamethasone for transplantation- eligible patients with newly diagnosed multiple myeloma (GRIFFIN): final analysis of an open-label, randomised, phase 2 trial","volume":"10","author":"Voorhees","year":"2023","journal-title":"Lancet Haematol"},{"issue":"suppl 16","key":"2024121115465012300_hem2024000580C39","doi-asserted-by":"crossref","first-page":"7502","DOI":"10.1200\/JCO.2024.42.16_suppl.7502","article-title":"Daratumumab + bortezomib\/lenalidomide\/dexamethasone in transplant-eligible patients with newly diagnosed multiple myeloma: analysis of minimal residual disease in the PERSEUS trial","volume":"42","author":"Rodriguez-Otero","year":"2024","journal-title":"J Clin Oncol"},{"key":"2024121115465012300_hem2024000580C40","doi-asserted-by":"crossref","first-page":"e810","DOI":"10.1016\/S2352-3026(22)00263-0","article-title":"Addition of isatuximab to lenalidomide, bortezomib, and dexamethasone as induction therapy for newly diagnosed, transplantation-eligible patients with multiple myeloma (GMMG-HD7): part 1 of an open-label multicentre, randomised, active- controlled, phase 3 trial","volume":"9","author":"Goldschmidt","year":"2022","journal-title":"Lancet Haematol"},{"issue":"suppl S1","key":"2024121115465012300_hem2024000580C41","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1182\/blood-2021-146040","article-title":"Daratumumab plus ixazomib, lenalidomide, and dexamethasone as extended induction and consolidation followed by lenalidomide maintenance in standard-risk transplant- eligible newly diagnosed multiple myeloma patients (IFM 2018-01)","volume":"138","author":"Perrot","year":"2021","journal-title":"Blood"},{"issue":"suppl 1","key":"2024121115465012300_hem2024000580C42","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1182\/blood-2023-177546","article-title":"Results of the phase III randomized Iskia trial: isatuximab-carfilzomib-lenalidomide-dexamethasone vs carfilzomib-lenalidomide-dexamethasone as pre-transplant induction and post-transplant consolidation in newly diagnosed multiple myeloma patients","volume":"142","author":"Gay","year":"2023","journal-title":"Blood"},{"issue":"23","key":"2024121115465012300_hem2024000580C43","doi-asserted-by":"crossref","first-page":"3945","DOI":"10.1200\/JCO.22.02567","article-title":"Daratumumab, cyclophosphamide, bortezomib, lenalidomide, and dexamethasone as induction and extended consolidation improves outcome in ultra-high-risk multiple myeloma","volume":"41","author":"Kaiser","year":"2023","journal-title":"J Clin Oncol"},{"issue":"11","key":"2024121115465012300_hem2024000580C44","doi-asserted-by":"crossref","first-page":"e890","DOI":"10.1016\/S2352-3026(23)00236-3","article-title":"Minimal residual disease response-adapted therapy in newly diagnosed multiple myeloma (MASTER): final report of the multicentre, single-arm, phase 2 trial","volume":"10","author":"Costa","year":"2023","journal-title":"Lancet Haematol"},{"issue":"2","key":"2024121115465012300_hem2024000580C45","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/bjh.17410","article-title":"Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology\/UK Myeloma Forum Guideline","volume":"193","author":"Sive","year":"2021","journal-title":"Br J Haematol"},{"issue":"6","key":"2024121115465012300_hem2024000580C46","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jtct.2022.03.019","article-title":"ASTCT clinical practice recommendations for transplantation and cellular therapies in multiple myeloma","volume":"28","author":"Dhakal","year":"2022","journal-title":"Transplant Cell Ther"},{"issue":"8","key":"2024121115465012300_hem2024000580C47","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1002\/ajh.26590","article-title":"Multiple myeloma: 2022 update on diagnosis, risk stratification, and management","volume":"97","author":"Rajkumar","year":"2022","journal-title":"Am J Hematol"},{"issue":"2","key":"2024121115465012300_hem2024000580C48","doi-asserted-by":"crossref","first-page":"2281657","DOI":"10.1080\/07853890.2023.2281657","article-title":"Survival trends and prognostic factors of patients with newly diagnosed multiple myeloma accompanied with extramedullary disease","volume":"55","author":"Wang","year":"2023","journal-title":"Ann Med"},{"issue":"12","key":"2024121115465012300_hem2024000580C49","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1038\/s41408-021-00587-0","article-title":"Primary plasma cell leukemia: consensus definition by the international Myeloma Working Group according to peripheral blood plasma cell percentage","volume":"11","author":"Fern\u00e1ndez de Larrea","year":"2021","journal-title":"Blood Cancer J"},{"issue":"10","key":"2024121115465012300_hem2024000580C50","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1016\/j.bbmt.2018.04.007","article-title":"Analysis of clinical factors and outcomes associated with nonuse of collected peripheral blood stem cells for autologous stem cell transplants in transplant-eligible patients with multiple myeloma","volume":"24","author":"Kansagra","year":"2018","journal-title":"Biol Blood Marrow Transplant"}],"container-title":["Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ashpublications.org\/hematology\/article-pdf\/2024\/1\/561\/2346682\/561perrot.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ashpublications.org\/hematology\/article-pdf\/2024\/1\/561\/2346682\/561perrot.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T20:16:58Z","timestamp":1733948218000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/hematology\/article\/2024\/1\/561\/526154\/Transplant-in-myeloma-who-when-and-why"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,6]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12,6]]},"published-print":{"date-parts":[[2024,12,6]]}},"URL":"https:\/\/doi.org\/10.1182\/hematology.2024000580","relation":{},"ISSN":["1520-4391","1520-4383"],"issn-type":[{"value":"1520-4391","type":"print"},{"value":"1520-4383","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,12,6]]},"published":{"date-parts":[[2024,12,6]]}}}