Autologous stem cell transplant (ASCT)
Very high-dose chemotherapy that would destroy the bone marrow, made survivable by giving the patient back their own previously collected stem cells. Standard in myeloma and relapsed lymphoma; the cells rescue the marrow, they do not fight the cancer.
Stem cells are mobilised with G-CSF (plus plerixafor), collected by apheresis and frozen; after melphalan (myeloma) or BEAM (lymphoma) conditioning they are reinfused and engraft in 10-14 days. ASCT after quadruplet induction remains standard for fit myeloma patients (PERSEUS, DETERMINATION) though CAR-T is challenging it (CARTITUDE-5/6); in DLBCL it has been displaced from second line by CAR-T (ZUMA-7, TRANSFORM) but remains for later relapse and for Hodgkin lymphoma and germ cell tumours; tandem transplant is part of high-risk neuroblastoma therapy. Mortality is 1-2%; risks are infection during aplasia and later secondary MDS.
Pages like this
not linked directly; found by shared links- TermBridging therapy
Shares Apheresis (leukapheresis), Salvage therapy, ZUMA-7.
- PairingEarly relapse: CAR-T before transplant
Shares TRANSFORM, ZUMA-7, Diffuse large B-cell lymphoma.
- TermGraft-versus-host disease (GVHD) and graft-versus-leukaemia
Shares Allogeneic stem cell transplant (allo-SCT), Conditioning regimen (myeloablative, reduced-intensity).
- TermUndetectable MRD (uMRD / MRD-negative)
Shares Allogeneic stem cell transplant (allo-SCT), VRd and Dara-VRd (myeloma induction regimens), Multiple myeloma.
- TermLymphodepletion before CAR-T
Shares Apheresis (leukapheresis), Conditioning regimen (myeloablative, reduced-intensity).
- Key paperTRANSFORM: liso-cel CAR-T versus salvage chemotherapy and transplant in early-relapsing large B-cell lymphoma
Shares TRANSFORM, ZUMA-7, Diffuse large B-cell lymphoma.
- IdeaOne CAR-T infusion instead of autologous transplant
Shares CARTITUDE-4, Multiple myeloma.
- TermAlkylating agents and antimetabolites
Shares Conditioning regimen (myeloablative, reduced-intensity), Melphalan (including hepatic delivery system).