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The treatment paradigm for multiple myeloma has evolved considerably over the past three decades with the incorporation of autologous stem cell transplantation (ASCT) in upfront therapy for eligible patients, and the use of novel agents. As a result, although multiple myeloma remains an incurable disease, clinical outcomes have significantly improved. In this chapter we will review the seminal studies that established the role of ASCT in multiple myeloma and as well as the current controversies with regard to the role of ASCT in the management of myeloma in the era of novel agents. We will review conditioning regimens, post-transplant maintenance strategies with novel agents and immune modulation. We will summarize the current data on early versus late ASCT, single versus tandem transplant and the role of ASCT in patients with relapsed or progressive disease.

Controversies in Autologous Stem Cell Transplantation for the Treatment of Multiple Myeloma