Catholic University Catholic Hematology Hospital

When is transplantation necessary? (Indications for transplantation)

Despite the significant progress made in the realm of targeted therapies and immunotherapies for multiple myeloma, hematopoietic stem cell transplantation still stands as the most esteemed consolidation therapy for this condition. Among the various treatment options available, it remains a crucial strategy, offering the possibility to markedly improve survival rates for patients. This procedure involves replacing the diseased bone marrow with healthy stem cells, which can develop into new, healthy blood cells, and serves as a cornerstone in the management of multiple myeloma.

• The target patient for transplantation is first determined by age; if below 70 years of age, autologous hematopoietic stem cell transplantation is actively performed.
• We're committed to providing autologous hematopoietic stem cell transplantation even to patients above the age of 69. Age is just a number - if their biological age is well-maintained and they're in good health, we believe there's no barrier to receiving this treatment.
• For many patients, maintenance chemotherapy is the preferred choice after autologous hematopoietic stem cell transplantation to keep cancer recurrence at bay. However, in some instances, a second round of autologous stem cell transplantation is selectively used as consolidation chemotherapy to further secure remission. This option is particularly encouraged for patients who've shown a less-than-optimal response to initial pre-transplant chemotherapy or have only reached partial remission after the transplantation. Moreover, a second autologous stem cell transplantation is advised for patients with specific genetic abnormalities like del(17p), t(4;14), t(14;16), 1q abnormality as our understanding of genetic factors continues to evolve.

▲ Reference: Korean multiple myeloma treatment strategy, 2023 by Chang-Ki Min

For newly diagnosed multiple myeloma patients, the process of autologous hematopoietic stem cell transplantation (AHSCT) typically involves several steps

• Diagnosis of Multiple Myeloma

  Under 70 years of age,
  in suitable general condition for transplantation

• Induction Chemotherapy

  4~6months,
  Supportive Care : Bone injections, hematopoietic growth factors, transfusions, etc.

• Preparation for Autologous Hematopoietic Stem Cell Transplantation

  Collection of autologous stem cells,
  pre-transplant evaluations, insertion of chemotherapy port

• Autologous Hematopoietic Stem Cell Transplantation

  on designated room with laminar airflow isolation

• Post-Transplantation Care

  Maintenance chemotherapy, supportive care

Catholic Hematology Hospital Offers Specialized Care

▲ 5-year survival rate of 72.4% in patients diagnosed in 2013.
Source : Seoul St. Mary's Hematology Hospital data