[Single vs double stem cell transplantation for the treatment of multiple myeloma]

High-dose therapy followed by autologous stem cell transplantation (ASCT) is the current optimal up-front treatment for younger, transplantation-eligible multiple myeloma patients, although the efficacy of double (tandem) ASCT remains unclear in previously untreated patients. According to published randomized trials and recent meta-analysis, double ASCT improved event-free survival and overall survival compared with single ASCT but increased transplant-related mortality. Double ASCT is now recommended for the treatment of patients who failed to achieve a very good response or better after the first transplantation. Further studies will be required to determine whether double ASCT is still needed in patients treated with highly effective novel agents.