Current Use of Tandem Transplant

Whether you have recently received a multiple myeloma diagnosis or you have been on this journey for longer, you’ve likely heard of stem cell transplantation. Continue reading to learn the most recent updates on stem cell transplantation and tandem transplantation, and hear more about others’ experiences in our most recent myeloma webinar. 

The Role of Stem Cell Transplantation in Multiple Myeloma Treatment

High-dose chemotherapy with melphalan followed by autologous stem cell transplantation remains a standard treatment for multiple myeloma. Although new therapies continue to improve, stem cell transplantation remains essential for achieving deep and long-lasting remissions that can extend for years or even decades.

What is Tandem Transplantation? 

Tandem transplantation is when a person undergoes two stem cell transplants within six months. This might be considered when a patient has high-risk myeloma. However, researchers are investigating whether tandem transplantation still provides significant benefits compared to a single transplant.

As newer treatments become available, it’s important to understand which patients benefit the most from stem cell transplantation (single or tandem). Modern medications have led to unprecedented remission rates, so it raises important questions about when and for whom transplantation remains the best option.

How Can I Learn From Others’ Experiences?

With the HealthTree community, you can hear and share experiences by joining our Regional Cure Teams. A recent webinar featured two self-advocate extraordinaires who shared their experiences with stem cell transplantation and encouraged other patients to volunteer in a Cure Team. 

Patrick Kelley was diagnosed with multiple myeloma in 2025 and is currently one of the volunteer HealthTree Coaches. Patrick shared his story from life before diagnosis to the challenges after and how he overcame them, along with his loved ones. 

Alan Stephenson was diagnosed with multiple myeloma in 2016 and is a passionate self-advocate who motivates others by sharing his story. 

Click the button below to watch Patrick and Alan’s stories in “Real Stories of Hope: Choosing Tandem Stem Cell Transplants and Thriving with Multiple Myeloma.” 

WATCH WEBINAR

LEARN MORE ABOUT CURE TEAMS

What Are The Most Recent Studies on Tandem Transplants? 

A recent study published in the Nature Scientific Journal compiled data from 12,763 patients recently diagnosed with multiple myeloma, distinguishing those who underwent single (8,736) or tandem ASCT (4,027) from 1998 to 2021.

This large study showed how the right timing of transplantation is crucial, as it can benefit patient outcomes. It also found important trends:

• The median age of patients undergoing transplantation increased from 59 years before 2008 to 61 years after 2017.
• The number of patients receiving tandem transplants declined over time, from 47% before 2008 to 26% after 2017.
• Tandem transplantation was more common among patients with early stages of myeloma and no kidney disease.

A recently published study in Blood analyzed 427 patients with multiple myeloma considered for a tandem transplant at King’s College Hospital in the UK between October 2018 and September 2023.  They also explored the factors that influenced whether patients proceeded with the second transplant. 

Patients with specific high-risk genetic markers, including t(4;14), t(14;16), TP53 deletion, or those who did not have the expected disease reduction with initial therapy, were typically considered for a tandem transplant. 

Researchers analyzed the percentage of patients who proceeded with the second transplant and the reasons why some did not. The results were the following: 

• Of the 392 patients who had a transplant for the first time, 12.7% were considered for a tandem transplant.
• Of the 47 patients who were considered, only 17% underwent the second autologous transplant.

The most common reasons for not undergoing a second transplant were:

• 38% of patients achieved a deep remission 100 days after the first transplant and continued with maintenance therapy instead.
• 13% had no documented reason, but most of these cases occurred during the COVID-19 pandemic, which may have affected treatment decisions.
• 11% had their treatment plan changed to focus on newer therapies, such as CAR-T therapy or maintenance medication.
• 8% of patients found the first transplant too difficult to tolerate and chose not to proceed with a second one.
• 6% of patients had their disease return before they could undergo the second transplant.

Looking Ahead: The Future of Stem Cell Transplantation

The decision to undergo stem cell transplantation should be personalized based on your response to initial treatment, overall health, and disease characteristics. Current guidelines from the National Comprehensive Cancer Network recommend collecting enough stem cells for two transplants in all eligible patients. A second transplant may be considered if you have high-risk disease or if you do not achieve a deep remission after the first transplant.

Stem cell transplantation is key in treating multiple myeloma, but there's still much to explore in combining it with new drug therapies. Ongoing research focuses on finding the most effective and least invasive treatments just for you. 

We're dedicated to developing free resources for you and your loved ones, so you have all the information that you need to make the best decisions for your care. If you are considering a stem cell transplant, click below and explore our patient guide:

ACCESS THE GUIDE

Sources: 

• Single versus tandem autologous stem cell transplantation in newly diagnosed multiple myeloma 
• Consideration of Tandem Autologous Stem Cell Transplant for Patients with Multiple Myeloma- a Large UK Single Centre Retrospective Analysis