TY - JOUR
T1 - ASTCT Clinical Practice Recommendations for Transplantation and Cellular Therapies in Multiple Myeloma
AU - Dhakal, Binod
AU - Shah, Nina
AU - Kansagra, Ankit
AU - Kumar, Ambuj
AU - Lonial, Sagar
AU - Garfall, Alfred
AU - Cowan, Andrew
AU - Poudyal, Bishesh Sharma
AU - Costello, Caitlin
AU - Gay, Francesca
AU - Cook, Gordon
AU - Quach, Hang
AU - Einsele, Herman
AU - Schriber, Jeff
AU - Hou, Jian
AU - Costa, Luciano
AU - Aljurf, Mahmoud
AU - Chaudhry, Maria
AU - Beksac, Meral
AU - Prince, Miles
AU - Mohty, Mohamad
AU - Janakiram, Murali
AU - Callander, Natalie
AU - Biran, Noa
AU - Malhotra, Pankaj
AU - Otero, Paula Rodriguez
AU - Moreau, Philippe
AU - Abonour, Rafat
AU - Iftikhar, Raheel
AU - Silberman, Rebecca
AU - Mailankody, Sham
AU - Gregory, Tara
AU - Lin, Yi
AU - Carpenter, Paul
AU - Hamadani, Mehdi
AU - Usmani, Saad
AU - Kumar, Shaji
N1 - Publisher Copyright:
© 2022 The American Society for Transplantation and Cellular Therapy
PY - 2022/6
Y1 - 2022/6
N2 - Over the past decade, therapeutic options in multiple myeloma (MM) have changed dramatically. Given the unprecedented efficacy of novel agents, the role of hematopoietic cell transplantation (HCT) in MM remains under scrutiny. Rapid advances in myeloma immunotherapy including the recent approval of chimeric antigen receptor (CAR) T-cell therapy will impact the MM therapeutic landscape. The American Society for Transplantation and Cellular Therapy convened an expert panel to formulate clinical practice recommendations for role, timing, and sequencing of autologous (auto-HCT), allogeneic (allo-HCT) and CAR T-cell therapy for patients with newly diagnosed (NDMM) and relapsed/refractory MM (RRMM). The RAND-modified Delphi method was used to generate consensus statements. Twenty consensus statements were generated. The panel endorsed continued use of auto-HCT consolidation for patients with NDMM as a standard-of-care option, whereas in the front line allo-HCT and CAR-T were not recommended outside the setting of clinical trial. For patients not undergoing auto-HCT upfront, the panel recommended its use in first relapse. Lenalidomide as a single agent was recommended for maintenance especially for standard risk patients. In the RRMM setting, the panel recommended the use of CAR-T in patients with 4 or more prior lines of therapy. The panel encouraged allo-HCT in RRMM setting only in the context of clinical trial. The panel found RAND-modified Delphi methodology effective in providing a formal framework for developing consensus recommendations for the timing and sequence of cellular therapies for MM.
AB - Over the past decade, therapeutic options in multiple myeloma (MM) have changed dramatically. Given the unprecedented efficacy of novel agents, the role of hematopoietic cell transplantation (HCT) in MM remains under scrutiny. Rapid advances in myeloma immunotherapy including the recent approval of chimeric antigen receptor (CAR) T-cell therapy will impact the MM therapeutic landscape. The American Society for Transplantation and Cellular Therapy convened an expert panel to formulate clinical practice recommendations for role, timing, and sequencing of autologous (auto-HCT), allogeneic (allo-HCT) and CAR T-cell therapy for patients with newly diagnosed (NDMM) and relapsed/refractory MM (RRMM). The RAND-modified Delphi method was used to generate consensus statements. Twenty consensus statements were generated. The panel endorsed continued use of auto-HCT consolidation for patients with NDMM as a standard-of-care option, whereas in the front line allo-HCT and CAR-T were not recommended outside the setting of clinical trial. For patients not undergoing auto-HCT upfront, the panel recommended its use in first relapse. Lenalidomide as a single agent was recommended for maintenance especially for standard risk patients. In the RRMM setting, the panel recommended the use of CAR-T in patients with 4 or more prior lines of therapy. The panel encouraged allo-HCT in RRMM setting only in the context of clinical trial. The panel found RAND-modified Delphi methodology effective in providing a formal framework for developing consensus recommendations for the timing and sequence of cellular therapies for MM.
KW - Allogeneic transplantation
KW - Autologous transplantation
KW - CAR T-cells
KW - Cellular therapy
KW - Consensus
KW - Multiple myeloma
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U2 - 10.1016/j.jtct.2022.03.019
DO - 10.1016/j.jtct.2022.03.019
M3 - Article
C2 - 35306217
AN - SCOPUS:85128352615
SN - 2666-6367
VL - 28
SP - 284
EP - 293
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 6
ER -