Role of transplantation in treatment of multiple myeloma in era of novel agents

Multiple myeloma (MM) is a B-cell malignancy characterized by clonal proliferation of plasma cells. Despite the introduction of novel agents such as immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies, high-dose chemotherapy with autologous transplantation remains the primary treatment for patients with newly diagnosed multiple myeloma. This review presents the results of clinical trials assessing the effectiveness and safety of various kinds of transplantation such as single, allogeneic, tandem and salvage. Nowadays, in the era of access to new therapies, the following questions should be asked: when is the best time to perform autologous transplantation? What is the significance of allogeneic or tandem transplantation? Is the use of a second or third salvage transplant justified? Will chimeric antigen receptor T-cell (CAR-T) therapy become a valuable therapeutic method in MM? In this article, we will try to answer these questions