[Allogeneic transplantation in multiple myeloma patients: results and recommendations in February 2010]

At this time, allogeneic transplantation should be offered only within the context of clinical trials. The likelihood of achieving prolonged complete remission with standard therapy with new drugs and autografting renders allogeneic transplantation unadvisable as first-line treatment in most patients. In this situation, the procedure must be reserved only for young patients with very poor prognostic factors or with progression of the disease offer receiving first-line treatment. After the first relapse, it should be applied to patients with an adverse cytogenetics and early relapse (< 18 months) after optimized treatment that includes new drugs and autologous transplantation. In any case, the patient should undergo transplantation with minimal disease. For the remaining patients, this procedure should not be considered the last therapeutic resort, since in this context there is a very low probability of success. On the other hand, conducting the procedure does not imply that the patient will not benefit a posteriori from other treatments, should they become necessary. Caution must be used when interpreting the available data from comparative studies. We have an obligation to continue exploring and improving this strategy which, to date, constitutes the most effective therapeutic tool available to us.