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Evolving Strategies in the Management of Transplant-Eligible Patients with Newly Diagnosed Multiple Myeloma.
Presse Med
December 2024
Service d'Hematologie, CHU de Toulouse - IUCT Oncopole, Université UPS Toulouse 3, Toulouse, France. Electronic address:
Multiple myeloma treatment has evolved significantly with the introduction of triplet and quadruplet regimens, notably incorporating anti-CD38 antibodies. While autologous stem cell transplantation remains a cornerstone of therapy, its role in the context of increasingly effective upfront treatments is debated. Current guidelines still recommend transplant for all eligible patients, especially those with high-risk features at diagnosis, despite concerns regarding the lack of overall survival benefits and the potential long-term toxicities associated with high-dose melphalan.
View Article and Find Full Text PDFNAD+ METABOLISM RESTRICTION BOOSTS HIGH-DOSE MELPHALAN EFFICACY IN PATIENTS WITH MULTIPLE MYELOMA.
Blood Adv
December 2024
IRCCS San Martino, Italy.
Elevated levels of the nicotinamide adenine dinucleotide (NAD+)-generating enzyme nicotinamide phosphoribosyltransferase (NAMPT) are a common feature across numerous cancer types. Accordingly, we previously reported pervasive NAD+ dysregulation in Multiple Myeloma (MM) cells in association with upregulated NAMPT expression. Unfortunately, albeit being effective in preclinical models of cancer, NAMPT inhibition has proven ineffective in clinical trials due to the existence of alternative NAD+ production routes utilizing NAD+ precursors other than nicotinamide.
View Article and Find Full Text PDFMitoxantrone-Based Novel Conditioning Regimen Leads to Great Survival Benefit in Peripheral T-Cell Lymphoma Compared to BEAM Regimen.
Cancer Med
December 2024
Department of Hematology, Huadong Hospital, Fudan University, Shanghai, China.
Background: Peripheral T-cell lymphomas (PTCL) frequently result in relapsed or refractory diseases. Upfront autologous hematopoietic stem cell transplantation (ASCT) using the BEAM (carmustine, etoposide, cytarabine, and melphalan) regimen is recommended. However, relapses are common in PTCL, highlighting a critical need for improved survival outcomes in these patients.
View Article and Find Full Text PDFTransplant in myeloma: who, when, and why?
Hematology Am Soc Hematol Educ Program
December 2024
Hematology Department, Toulouse University Hospital, Institut Universitaire du Cancer de Toulouse-Oncopole CHU Toulouse, Toulouse, France.
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.
View Article and Find Full Text PDFBusulfan and cyclophosphamide for autologous stem cell transplantation in patients with multiple myeloma after proteasome inhibitor and/or immunomodulatory drug treatment.
Sci Rep
November 2024
Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
High-dose melphalan at 200 mg/m (MEL-200) is the standard conditioning regimen before autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM). Busulfan (BU) and cyclophosphamide (CY) can be used as alternatives when MEL is unavailable. However, most studies on BU/CY conditioning regimens were conducted before proteasome inhibitors (PIs) and immunomodulatory drugs (IMIDs) were available.
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