- Country: TAIWAN
- Official Title: 科主任
- Department: 臺北榮民總醫院輸血醫學科
Speech Title
ASCT in Multiple Myeloma, History or Future?
Autologous stem cell transplant (ASCT) serves as a critical intervention for selected multiple myeloma patients, characterized by high-dose chemotherapy (HDT) followed by the reinfusion of the patient’s own hematopoietic stem cells to achieve deep disease remission. This personalized treatment modality requires careful consideration of the patient’s unique disease characteristics and overall health, with eligibility extending beyond age to factors such as physiologic condition and treatment history. Optimal timing for ASCT can vary, often integrated as frontline therapy or deferred until relapse based on the initial response. Induction therapies preceding ASCT aim to maximize tumor reduction while preserving stem cell viability, with contemporary regimens including agents like daratumumab, bortezomib, and lenalidomide, enhancing long-term outcomes. The procedure, while offering significant potential for prolonged disease control, carries inherent risks like infection and organ toxicity, necessitating rigorous supportive care and vigilant monitoring. Post-transplant care is crucial, focusing on symptom management, infection prevention, and gradual immunological reconstitution through strategic re-immunization based on established guidelines. Overall, ASCT remains a pivotal but complex treatment requiring nuanced clinical judgment and close patient-specialist collaboration to optimize therapeutic success and quality of life.