NCCN Guidelines for Patients® | Multiple Myeloma - page 57

55
NCCN Guidelines for Patients
®
Multiple Myeloma, Version 1.2014
Chart 4.4.7
shows the treatments that are
recommended after an autologous stem cell transplant.
An autologous stem cell transplant is a treatment in
which your blood stem cells are removed, stored,
and then returned. Which treatment is recommended
depends on how the myeloma responded to the
transplant. A treatment response is an outcome or
improvement related to treatment. See page 45 to read
about the types of possible treatment responses.
If tests show a treatment response or stable
disease after the stem cell transplant,
you have
three treatment options to choose from. The first
option is to receive maintenance treatment—medicine
given in a lower dose or less frequently to “maintain”
good initial treatment results. (See Chart 4.4.5 on
page 52 for a list of maintenance treatment options.)
The second option is to receive a tandem stem cell
transplant with or without maintenance treatment. A
tandem transplant is a second round of high-dose
chemotherapy followed by a second autologous stem
cell transplant given within 6 months of the first
transplant. The third option is to begin observation—a
period of testing to watch for cancer growth.
If tests show progressive disease after any of the
treatments described above, you have two more
treatment options to choose from. The first option
is to receive additional treatment, with or without
another autologous stem cell transplant. A treatment
response lasting at least 2 to 3 years prior to
progression is suggested for consideration of another
transplant. (See Chart 4.4.3 on page 50 for a list of
recommended additional treatment options.) The
second option is to receive an allogeneic stem cell
transplant within a clinical trial.
If tests show progressive disease after the stem
cell transplant,
then you have two treatment options
to choose from. One option is to receive additional
treatment, possibly within a clinical trial. (See Chart
4.4.3 on page 50 for additional treatment options.)
The other option is to receive an allogeneic stem cell
transplant as part of a clinical trial.
4
Treatment guide
Active multiple myeloma
Test results
Next treatment
Response or
stable disease
Chart 4.4.7 Treatment after autologous stem cell transplant
Maintenance treatment,
Tandem stem cell transplant
+ maintenance treatment, or
Observation
Additional treatment on or off clinical trial, or
Allogeneic stem cell transplant on clinical trial
Progressive
disease
Progressive
disease
Additional treatment on or off
clinical trial + autologous stem
cell transplant, or
Allogeneic stem cell transplant
on clinical trial
1...,47,48,49,50,51,52,53,54,55,56 58,59,60,61,62,63,64,65,66,67,...82
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