High dose chemotherapy followed by autologous stem cell transplantation has been recognized as an important step in the treatment of multiple myeloma. At least two well designed randomized studies showed better outcomes in patients treated with high doses compared to those treated with conventional chemotherapy. Nowadays, autologous stem cell transplantation should be considered for all under 65-year-old patients. Although autologous stem cell transplantation has modified the prognosis of myeloma, almost all patients still relapse some time after a single transplant, and then another therapeutic approach becomes necessary. With the aim of improving the results in the treatment of myeloma, new approaches including tandem stem cell transplantation, maintenance with thalidomide and new drugs such as bortezomib are being tested. Strategies including these approaches and autologous stem cell transplantation may improve the results of the treatment of myeloma in the future.
Multiple myeloma; hematopoietic stem cell transplantation; autologous
