The Fellow on Call: The Heme/Onc Podcast Episode 147: Myeloma Series, Pt. 7 - Transplant Consolidation for Multiple Myeloma (2026)
Mar 11, 2026
A deep dive into transplant consolidation for multiple myeloma, highlighting three pivotal trials and how timing of autologous transplant affects outcomes. Discussion covers continuous maintenance strategies, MRD-directed approaches, and emerging therapies like bispecifics and CAR-T. Practical takeaways on current practice and ongoing trials are reviewed.
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Early Transplant Improves PFS Not OS
- Early autologous stem cell transplant improves progression-free survival compared with delayed transplant.
- IFM 2009 showed 8-year PFS 35% with early transplant versus 23% with deferred transplant, but no overall survival difference.
Continuous Maintenance Extends PFS
- Continuous lenalidomide maintenance until progression increases PFS versus fixed one-year maintenance.
- DETERMINATION median PFS was 67 months versus 46 months, suggesting prolonged maintenance meaningfully extends remission.
Use MRD To Personalize Transplant Decisions
- Use MRD to individualize transplant decisions and consider stopping maintenance for sustained MRD-negative patients.
- Hosts suggest trials like MASTER-2 will refine which patients can avoid transplant based on MRD.