Stem Cell Transplantation for Multiple Myeloma

One of the first decisions a doctor makes after giving a multiple myeloma diagnosis is deciding whether the patient is a candidate for a stem cell transplant.

For some patients, such as those who have other serious medical conditions, the risk of a stem cell transplant may outweigh the benefits.

But for people who are healthy enough for a stem cell transplant, this may be the treatment of choice, with the best prognosis.

Stem cells are cells found in the blood and bone marrow that develop into red blood cells, white blood cells, and platelets. A stem cell transplant aims to replace cancerous stem cells with healthy ones.

There are two types of transplant:

Autologous Transplant Doctors collect stem cells from the patient’s blood, treat the patient with high-dose chemotherapy and (sometimes) radiation, and return the stem cells to the patient intravenously. The stem cells make their way back to the bone marrow, where they begin to grow and multiply. Sometimes doctors recommend patients have a tandem transplant — two autologous transplants 6 to 12 months apart.

Allogeneic Transplant Doctors use stem cells from a donor whose genetics closely match the patient’s, such as a sibling. This is a riskier approach than an autologous transplant but can have better results because donor stem cells can destroy myeloma cells.  

Radiation Therapy for Multiple Myeloma

Doctors may use radiation therapy to treat areas of bone that have been damaged by multiple myeloma, aren’t responding to chemotherapy, and are causing pain or are in danger of breaking.

Radiation is also the most common treatment for solitary tumors in bone or soft tissue. 

Clinical Trials and Experimental Therapies

Researchers are striving to develop new treatment approaches for multiple myeloma, such as new drugs, new drug combinations, and new approaches for stem cell transplantations.

Scientists are also probing the genetics of myeloma cells in order to identify standard and high-risk disease.

Immunotherapy may have the potential to change the game in multiple myeloma treatment. A new drug of this type focuses on an immune-system cell called a T cell, a type of white blood cell.

Chimeric antigen receptor T-cell therapy (CAR T-cell therapy) empowers T cells to fight multiple myeloma by changing them in the lab so they can identify and kill cancer cells.

Recent studies have shown CAR T-cell therapy with the BCMA protein to be very promising, even in myeloma patients who have had treatment with many other drugs.

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