This is the fourth and last part of our series about the condition based on our patient booklet “Fast Facts for Patients and their Supporters: Myeloma”, which is freely available online. This article deals with the possibilities of stem cell transplantation.

For patients who are considered fit enough (those younger than 65 years in many countries; 75 years in the USA), the combination of autologous stem cell transplantation (ASCT) and chemotherapy can produce long symptom-free periods. About 35% of newly diagnosed patients are considered eligible for this treatment. Patients whose genetic assessment suggests they have a standard risk of disease progression tend to get better outcomes with this treatment than those at higher risk.

What Is ASCT?

Stem cells are an early form of blood cell made in the bone marrow, which can develop into white blood cells (including the plasma cells affected in myeloma), red blood cells or platelets. In ASCT, your own stem cells are harvested (‘autologous’ means coming from your own body) when you are symptom free (remission). The cells are then used to produce new, healthy, plasma cells.

Stem cells produced in the bone marrow can develop into red blood cells, white blood cells or platelets.

Once your myeloma is under control, you may be offered long-term maintenance therapy as part of a clinical trial to prolong the remission period for as long as possible. Your doctor will be able to advise you about this.

Can Stem Cells Be Taken From A Donor?

The use of donor stem cells (allogeneic stem cell transplantation) is being investigated in myeloma (only a small number of people receive this treatment outside clinical trials). However, this approach has so far been much less successful than it has been in the treatment of leukemia. This may change as new conditioning therapies become available. Also, this procedure is largely suitable for people under 50 years of age, who make up less than a quarter of myeloma patients.

Please check out the other posts of our series here:

• What Is Myeloma, How Is It Diagnosed, Who Gets It, and Why?
• What Are the Types and Effects of Myeloma?
• Myeloma: What Treatment Will I Receive?

Information based on Fast Facts for Patients and their Supporters: Myeloma (Karger, 2017).