A new study has indicated the possible advantages of stem cell transplantation for patients with Multiple Myeloma, a cancer of plasma cells. Dr Antonio Palumbo: "This study shows a longer progression-free survival time with hematopoietic stem cell transplantation in comparison to conventional chemotherapy." The outcome of this study is presented at the 16th Congress of the European Hematology Association in London.

Multiple myeloma is the second most common hematologic malignancy, with a higher incidence in patients over 65 years. Although the disease remains incurable, the introduction of novel agents, such as the immunomodulatory drugs thalidomide and lenalidomide and the proteasome inhibitor bortezomib, has significantly changed the treatment paradigm of this disease and considerably improved outcomes. High-dose therapy is considered the standard treatment for younger patients, while older patients benefit more from a gentler approach.

Dr Antonio Palumbo from the Division of Hematology of the University of Torino, AOS S. Giovanni Battista in Torino: "We have compared the role of high-dose chemotherapy (MEL 200) followed by hematopoietic stem cell transplantation with novel agents versus conventional chemotherapy with novel agents.

The available literature on melphalan-prednisone plus novel agents suggested that novel agent-containing regimens might have the same impact on response rate as hematopoietic stem cell transplantation. Therefore, in our study we compared high dose melphalan MEL 200 followed by hemaotopoietic stem cell transplantation versus conventional melphalan-prednisone plus the novel agent lenalidomide (MPR) in patients with newly diagnosed multiple myeloma who received induction treatment with lenalidomide and low-dose dexamethasone.

Despite comparable response rates between the two arms, MEL200 showed a longer progression-free survival. This is the first study showing a longer progression-free survival time with hematopoietic transplantation with novel agents in comparison to conventional chemotherapy with novel agents. To date, it is not possible to assess the impact of either approach on overall survival, and longer follow-up is needed to draw any definitive conclusions. Our results also confirmed that in the era of novel agents, high-dose chemotherapy followed by hematopoietic stem cell transplantation remains the essential strategy in younger patients with multiple myeloma."

About the EHA Annual Congress

After 15 congresses and constantly increasing number of delegates, the 16th Congress of EHA will take place in London. Hematology is a specialty that covers everything to do with blood: its origin in the bone marrow, diseases (in the production) of blood and their treatments. The latest data on research and developments within the wide spectrum of hematology are presented. The Congress is aimed at health professionals working in or interested in the field of hematology. The scientific program topics range from stem cell physiology and development, to leukemia; myeloma; lymphoma; diagnosis and treatment; red blood cells; white blood cells and platelet disorders; hemophilia; thrombosis and bleeding disorders as well as transfusion and stem cell transplantation. Last year the congress in Barcelona welcomed over 9,000 participants.

European Hematology Association