Stem Cell Transplant More Effective Than Chemotherapy as First
Line Treatment for Multiple Myeloma
Stem cell transplantation is more effective than standard
chemotherapy as the first-line treatment for patients with multiple myeloma, a
panel of independent experts has concluded. The treatment recommendation was
made after an extensive analysis of published medical literature and was
reported in the January 2003 issue of Biology of Blood and Marrow
Transplantation.
The panel, which was convened by the American Society of Blood
& Marrow Transplantation, included experts on the entire spectrum of
treatment options for multiple myeloma, stem cell transplant experts, a
third-party payer organization and a patient advocate. The group reviewed
studies that were published in recognized medical journals between January 1980
and June 2002 that addressed the role of stem cell transplantation in the
treatment of patients with multiple myeloma.
"This information is important for multiple myeloma patients and
their physicians as they make treatment decisions and seek reimbursement from
health insurers for transplantation," said John Wingard MD, University of
Florida College of Medicine, and chair of the expert panel on multiple myeloma.
The panel also determined that:
- Using stem cells collected from the bloodstream (peripheral
blood stem cells) is preferable to bone marrow when transplanting patients with
multiple myeloma
- "Purging" bone marrow of myeloma cells is not effective with
the current technology
Although studies of other approaches to transplantation, such as
tandem transplantation, were reviewed, the panel concluded there was
insufficient evidence currently available to make a firm recommendation. "As
useful as this review is, it has its limitations," cautions Dr. Wingard.
Evidence emerging from on-going studies may shed new light on optimal treatment
strategies for patients with multiple myeloma, he notes. "It's important that
reviews such as this one are periodically revisited to update the evidence and
evaluate the impact on recommendations."
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