Stem cell transplant for multiple myeloma
Stem cell (or bone marrow) transplant is a treatment where high doses of chemotherapy (sometimes with radiation) is given to try kill as many cancer cells. This treatment is so strong that it doesn’t only kill cancer cells – it also kills the normal blood forming cells in the bone marrow. In order for the patient to survive this treatment, healthy stem cells are given to the patient after the chemotherapy (chemo). These stem cells go to the bone marrow and start making new blood cells.
This has become the standard treatment for myeloma patients in good health.
The 2 types of stem cell transplant (SCT) are:
If the patient’s own stem cells are used, it is called an autologous transplant. These transplants are fairly safe and do not have a high risk of death and other serious complications. Because of this, they can be used for older patients. But it is hard to kill all the myeloma cells with the treatments used. Because of this, myeloma returns later in most patients who have autologous transplants. A few patients will be free of myeloma for a long time, but this procedure doesn’t cure the disease.
Autologous transplants are better than regular chemo at treating myeloma and help patients live longer. They are a standard part of myeloma treatment. Some doctors recommend that patients have 2 autologous transplants, 6 to 12 months apart. This approach is called tandem transplant. Studies show that this may help patients live longer than a single transplant. The drawback, of course, is that it causes more side effects.
When stem cells from a donor are used, the transplant is called an allogeneic transplant. The donor is usually a close relative. Less often, it is an unrelated person whose tissue type closely matches that of the patient. Allogeneic transplants are much riskier than autologous transplants, but they may be better at fighting the cancer. That’s because transplanted (donor) cells may actually help destroy myeloma cells. This is called a graft vs. tumor effect. Still, in studies of multiple myeloma patients, those who got allogeneic transplants often did worse in the short term than those who got autologous transplants. At this time, allogeneic transplants are not considered a standard treatment for myeloma, but may be done as a part of a clinical trial.
For more information about stem cell transplant, see our document Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants).
Our document Multiple Myeloma also has more information about using stem cell transplants to treat myeloma.
Last Medical Review: 05/22/2014
Last Revised: 01/19/2016