Nonmyeloablative reduced-intensity transplantation in multiple myeloma

Reduced-intensity conditioning (RIC) allogeneic transplants are being performed more frequently in a variety of hematologic malignancies. The aim is to exploit the graft-versus-tumor (GVT) effect seen after allografting without the toxicities of myeloablative conditioning. RIC regimens are being extensively explored for salvage therapy of myeloma. Although nonrelapse mortality rates are acceptable, relapse remains the most common cause of treatment failure. New combinations and novel therapies need to be explored to improve outcomes. This strategy should also be employed earlier in the course of the disease.