Induction Therapy Before Transplantation in Multiple Myeloma: New Strategies to Achieve Complete Response

The application of high-dose therapy combined with stem cell support has greatly improved the outcome of treatment in patients with multiple myeloma. However, induction treatments are rapidly changing, and it has now become possible to achieve complete responses in 30%-40% of newly diagnosed patients before high-dose therapy. The effect of the improved induction regimens on the results of the whole treatment strategy and the long-term outcome will have to be evaluated in prospective randomized trials. The introduction of new drugs such as thalidomide and bortezomib have contributed significantly to this changed remission status and may ultimately lead to a change of concept about the value of remission-induction therapy. In this article, we review various regimens that are used for induction therapy in preparation for stem cell transplantation and describe the impact these novel agents could have on patient remission status.