51 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 4 Treatment guide Active (symptomatic) multiple myeloma Guide 7. Treatment after allogeneic stem cell transplant Test results Next treatment options Next options for progressive disease Treatment response or stable disease ª • Maintenance therapy as part of a clinical trial • Observe ª • Therapy for previously treated myeloma • Clinical trial • Donor lymphocyte infusion Progressive disease ª Guide 7 shows the treatment options that may be used after an allogeneic stem cell transplant. An allogeneic transplant is a treatment in which you receive healthy blood stem cells from another person. The next treatment options depend on how the myeloma responded to the stem cell transplant. A treatment response is an outcome or improvement caused by treatment. See page 46 to read about the types of treatment responses. If tests show a treatment response or stable disease, then you have two treatment options to choose from. One option is to receive maintenance therapy as part of a clinical trial. Maintenance therapy is medicine given in a lower dose or less often to keep (maintain) the good results of prior treatments. The second option is to begin observation—a period of testing to watch for cancer growth. If myeloma returns or gets worse after either of these options, then you will have treatment for progressive disease as described below. If tests show progressive disease, then you have a few treatment options to choose from. The first option is to receive additional treatment, possibly within a clinical trial. Additional treatment is given after prior treatments are not working and the cancer remains or continues to grow. A doctor may also recommend you receive a donor lymphocyte infusion. A donor lymphocyte infusion is when you are given white blood cells called lymphocytes from the same donor used for the allogeneic stem cell transplant.