Considerations for Optimizing Transplant in Multiple Myeloma Patient Management
Various strategies have been used to control disease and improve outcomes in myeloma. High-dose chemotherapy with autologous stem cell transplant (HDT-ASCT) is considered a standard approach to improve response, and the increased depth of response achieved after ASCT appears to correlate with longer term disease control. Used as induction therapy, novel agents offer improved depth of response, with newer next-generation agents offering the hope of even further gains. This, along with the increasing use of novel agents for extended treatment, is a driving force behind the delay in timing of ASCT, including to that of second-line therapy or beyond. Although upfront ASCT remains a cornerstone of myeloma treatment, it is not considered a requirement in eligible patients. Qualified transplant patients opting not to go for immediate ASCT is not an uncommon occurrence in current clinical practice and is likely to become even more prevalent. In addition to timing, another consideration is the opportunity to improve response with alternative conditioning regimens.
This activity will focus on the role of stem cell transplantation in the novel-agent era as well as defining the goal of therapy and strategies for induction and maintenance in transplant-eligible patients.
After completing this program, participants should be able to:
1.Identify factors that might determine eligibility for and timing of high-dose chemotherapy (HDT) followed by autologous stem cell transplant (ASCT) in patients with multiple myeloma (MM)
2.Differentiate treatment strategies for patients with newly diagnosed multiple myeloma who are eligible for HDT/ASCT
3.Identify barriers in access to HDT/ASCT for MM
4.Review the rationale for conditioning regimens in patients with multiple myeloma who are eligible for HDT/ASCT
5.Compare and contrast pertinent data regarding a new formulation of melphalan
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-sponsorship of Medical Education Resources (MER) and PleXus Communications. MER is accredited by the ACCME to provide continuing medical education for physicians.
Medical Education Resources designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
Medical Education Resources is an approved provider of continuing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.
This CE activity provides 1.0 contact hours of continuing nursing education.
Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1.0 contact hour.
Educational Review Systems is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program is approved for 1 hour (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.
UAN # 0761-9999-16-015-L01-P
Disclosures of Conflicts of Interest:
It is the policy of Medical Education Resources (MER) to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to contrl the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported or used in CME activity conforms to the generally accepted standards of experimental design, data collection, and analysis.
There is no fee for this educational activity.
Rafat Abonour, MD
Omar Aljitawi, MD
University of Kansas Hospital
William Bensinger, MD
Seattle Fred Hutchinson Cancer Center
Luciano Costa, MD
University of Alabama at Birmingham
John DiPersio, MD
Washington University School of Medicine Barnes-Jewish Hospital
Greg Eskinazi, RPh
Hackensack University Medical Center
Don Hutcherson, RPh
Emory University Hospital
Heather Landau, MD
Memorial Sloan Kettering Cancer Center
Ed Stadtmauer, MD
University of Pennsylvania
Steve Trifilio, PharmD
Northwestern Memorial Hospital
Ravi Vij, MD
University of Washington