Dr. Parameswaran Hari, MD, MRCP, MS

Interview date: January 24, 2014

Who should consider an allogenic (donor) transplant? You may be surprised. While it is not for everyone, Dr. Hari describes myeloma patients who are to benefit the most from allogeneic translpant: young, high-risk patients, patients that relapse quickly (in 1-2 years after treatment) or plasma cell leukemia patients. Allo transplants are the oldest immunotherapy in in the book - the donor's immune cells find and kill the myeloma cells. Dr. Hari shares how safety has jumped in recent years from prior dismal rates to a 5% mortality rate in young patients because of new transplant methods and new drugs. Dr. Hari describes the "mini" allo transplant, the "reduced intensity" allo transplant and why you may want to do an auto then an allo transplant in tandem. He previews a large, multi-center study that will open in a few months for high risk patients or those with a single relapse using the allo transplant with or without an oral proteasome inhibitor. For those who are struggling to find a matching donor in the Be The Match registry, Dr. Hari describes a very interesting early study that uses a family half-matched family donor (like a sibling) with natural killer cells - what looks like a very effective immunotherapy one-two punch to kill myeloma cells. He emphasizes (again!) that we should do deep diagnostic testing at a myeloma academic center so we will be positioned later to learn which treatments are better for which types of patients. If we start treatment without correct diagnostics, that information is lost. 

The live mPatient Myeloma Radio podcast with Dr. Parameswaran Hari