ASTCT Clinical Practice Recommendations for Transplantation and Cellular Therapies in Multiple Myeloma

Dhakal B, Shah N, Kansagra A, Kumar A, Lonial S, Garfall A, Cowan A, Poudyal BS, Costello C, Gay F, Cook G, Quach H, Einsele H, Schriber J, Hou J, Costa L, Aljurf M, Chaudhry M, Beksac M, Prince M, Mohty M, Janakiram M, Callander N, Biran N, Malhotra P, Otero PR, Moreau P, Abonour R, Iftikhar R, Silberman R, Mailankody S, Gregory T, Lin Y, Carpenter P, Hamadani M, Usmani S, Kumar S (2022)

Publication Type: Journal article

Publication year: 2022


Book Volume: 28

Pages Range: 284-293

Journal Issue: 6

DOI: 10.1016/j.jtct.2022.03.019


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.

Involved external institutions

University of Pennsylvania US United States (USA) (US) University of Washington US United States (USA) (US) Civil Service Hospital NP Nepal (NP) University of Leeds GB United Kingdom (GB) Oregon Health and Science University (OSHU) US United States (USA) (US) Medical College of Wisconsin (MCW) US United States (USA) (US) University of California San Francisco (UCSF) US United States (USA) (US) Moores Cancer Center US United States (USA) (US) University of Turin / Università degli Studi di Torino (UNITO) IT Italy (IT) The University of Melbourne AU Australia (AU) Universitätsklinikum Würzburg DE Germany (DE) Cancer Treatment Centers of America US United States (USA) (US) Shanghai Jiao Tong University / 上海交通大学 CN China (CN) University of Alabama at Birmingham (UAB) US United States (USA) (US) King Faisal Specialist Hospital & Research Centre SA Saudi Arabia (SA) George Washington University Hospital US United States (USA) (US) Ankara University / Ankara Üniversitesi TR Turkey (TR) Universidad de Navarra ES Spain (ES) Armed Forces Bone Marrow Transplant Centre (AFBMTC) PK Pakistan (PK) Memorial Sloan Kettering Cancer Center US United States (USA) (US) Colorado Blood Cancer Institute (CBCI) US United States (USA) (US) Mayo Clinic US United States (USA) (US) University of Texas Southwestern Medical Center (UT Southwestern) US United States (USA) (US) University of South Florida (USF) US United States (USA) (US) Emory University US United States (USA) (US) University of Paris 4 - Paris-Sorbonne / Université paris IV Paris-Sorbonne FR France (FR) City of Hope Medical Center US United States (USA) (US) University of Wisconsin - Madison US United States (USA) (US) Hackensack Meridian Health US United States (USA) (US) Postgraduate Institute of Medical Education and Research IN India (IN) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) FR France (FR) Indiana University – Purdue University Indianapolis US United States (USA) (US)

How to cite


Dhakal, B., Shah, N., Kansagra, A., Kumar, A., Lonial, S., Garfall, A.,... Kumar, S. (2022). ASTCT Clinical Practice Recommendations for Transplantation and Cellular Therapies in Multiple Myeloma. Transplantation and Cellular Therapy, 28(6), 284-293.


Dhakal, Binod, et al. "ASTCT Clinical Practice Recommendations for Transplantation and Cellular Therapies in Multiple Myeloma." Transplantation and Cellular Therapy 28.6 (2022): 284-293.

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