When Should You Get a Stem Cell Transplant for Multiple Myeloma?
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/ Updated February 11th, 2022

When Should You Get a Stem Cell Transplant for Multiple Myeloma?

Medically Reviewed: Dr. Brandon Blue Written by Stephanie Watson
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Stem Cell Transplants for Multiple Myeloma

  • An autologous stem cell transplant replaces abnormal multiple myeloma cells in your bone marrow with healthy blood-forming cells.
  • Autologous means the stem cells come from your own body.
  • The best candidates for a stem cell transplant are younger than 65 and don’t have underlying medical conditions, but some older patients qualify, too.
An autologous stem cell transplant replaces the abnormal cancer cells in your bone marrow with healthy stem cells taken from your own body. It's often part of the treatment for multiple myeloma, because it offers you a good chance at a long-term remission.

RELATED: Determining if You Need a Stem Cell Transplant for Multiple Myeloma

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"Stem cell transplant, in my opinion, still remains the standard of care at this time," Dr. Sumit Madan tells SurvivorNet. He's a multiple myeloma specialist at Banner MD Anderson Cancer Center in Arizona.

Who Can Get a Stem Cell Transplant?

A stem cell transplant is a pretty intense procedure. You need be healthy enough to withstand it, with no major medical issues to complicate things. Doctors usually recommend the treatment for people under age 70, but that's not a hard and fast rule.

"In the United States, we do not have an age cutoff for autologous stem cell transplant," Dr. Madan says. "We can transplant patients all the way up to 80 years old." But, he adds, they need to be in reasonably good health.

Harvesting Your Stem Cells

If you are eligible for a stem cell transplant, you'll get four – six cycles of induction therapy. Usually this involves getting a combination of three drugs to kill off as many of the cancer cells as possible. Then you'll have an autologous stem cell transplant.

"By autologous, I mean the patient’s own cells are given back," Dr. Madan says. It’s different from an allogeneic stem cell transplant, which uses cells from a donor. Using your own cells is preferred because it leads to fewer complications.

RELATED: How Does a Stem Cell Transplant Work?

The stem cells come from your bone marrow. First, you'll get injections of growth factors. These will make your bone marrow release stem cells into your blood.

Then your medical team will harvest your stem cells. They do this by passing your blood through a machine that separates out the stem cells. The rest of the blood goes back into your body.

The Transplant

You'll then get high-dose chemotherapy to destroy the myeloma cells in your bone marrow. This treatment also destroys healthy bone marrow. Afterward, you'll get an infusion of your stem cells.

It takes about 10 to 14 days for those new stem cells to start producing enough blood cells. Your health care team will make sure you don’t get any infections during the time it takes for your blood counts to come up, Dr. Madan says.

How Well Does a Transplant Work?

"An autologous stem cell transplant has shown to improve survival, especially in patients with high-risk multiple myeloma," Dr. Madan says. In the 15 to 20% of myeloma patients with high-risk disease, a stem cell transplant can lead to deeper remissions.

In a 2021 study called FORTE, people who received induction therapy with carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone followed by a stem cell transplant were less likely to relapse early than those who didn’t get the transplant.

A stem cell transplant is a major procedure. You need to be healthy enough to handle the high-dose chemotherapy it requires. It's important to make sure that you're a good candidate before having this procedure. Talk through all of your options with the doctor who treats your multiple myeloma. And if you're not sure about the treatment your doctor recommends, seek out a second opinion.

Learn more about SurvivorNet's rigorous medical review process.

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