Autologous SCT

Autologous stem cell transplantation involves the collection of the patients’ own stem cells which are subsequently given back to them.

Factors to consider in determining whether a patient is a suitable candidate for HDT and autologous SCT include:

• Age – normally limited to younger and/or fitter patients however each patient is assessed individually and risk is assessed based on age and comorbidities. Various assessment tools such as the Myeloma Frailty Score Calculator may be used to help guide treatment decision making.
• Renal function – patients with renal failure are generally not eligible but those with renal impairment (creatinine clearance < 30mls/min) may be considered for autologous SCT using a lower dose of melphalan and dialysis can be used alongside the treatment
• Patient preference – the quality of life and duration of response associated with the treatment outcome incorporate elements of personal choice – therefore patient preference is an important consideration

HDT-SCT carried out either as part of initial treatment or at relapse, is now an integral part of myeloma treatment for those who are eligible. Whilst it is not curative, event-free survival and overall survival are prolonged following HDT and autologous SCT compared to treatment with conventional chemotherapy. While many stages of HDT-SCT require an inpatient stay, with the evolution of nursing practice and treatment delivery, ambulatory care provisions allow many patients to spend less time in hospital.