Second transplant

Having a second transplant at the time of relapse is different to a tandem transplant, where two transplants are planned at the outset.

A second transplant is recommended for first relapse patients who have had >18 months response to the first transplant, and often enough stem cells will have been stored for use in these circumstances. A course of conventional anti-myeloma treatment is given to reduce the bulk of the disease before the second transplant is performed.

Whether a second transplant is an option will depend on the timing of the relapse, age, previous treatment given, general fitness to undergo the procedure again. Decisions should be based on the potential benefits versus the risks and the impact it may have on patients’ quality of life.

Further reading

Drozd-Sokolowska et al. (2022) Autologous hematopoietic cell transplantation for relapsed multiple myeloma performed with cells procured after previous transplantation–study on behalf of CMWP of the EBMT. Bone Marrow Transplantation 57, 633–640.

Haygen & Stiff (2019) The Role of Salvage Second Autologous Hematopoietic Cell Transplantation in Relapsed Multiple Myeloma. Biol Blood Marrow Transplant 25(3):e98-e107