Why consider an allo transplant in the age of novel therapies?

Why consider an allo transplant in the age of novel therapies?

For sure the introduction of novel agents has increased on average the amount of time that myeloma patients live, for sure. Without a doubt. I think that the notion of novel agents curing patients at this point curing people is weird because you can't do something and say oh my god, you're cured. If you think about it being cured is the absence of you relapsing. So you have to wait, and wait, and wait, and wait, and wait, and wait. And then if it doesn't come back, you say, Well, I think you're probably cured. So it takes a long time to figure that out.

And I think that with novel agents, it may be that you get an early transplant and you're done and you're cured, like that's a possibility. Whereas the other possibility is you go through novel agent after novel, agent after agent, after agent after agent, and go time after time after time after time. So there's just different ways of getting at it. And I think that just like people are different, their expectations and what they want is different. So some people say, look, I got this. I just want to get rid of it and just be done with it. Other people say, look, I've got this and, I want to do what's the right thing to do. But I don't want to do something crazy like an allo transplant. And I would say, look, none of those answers is wrong under the right circumstances.

And so a lot of it has to do with the patient. Whether the patient want I think most people would say, look, it's an aggressive thing to do it at the transplant. But, part of where I come from is I'm an allo transplanter. And so for me, it's not as big of a leap because I do allogeneic transplanting in leukemia patients and lymphoma patients. And there are no autologous stem cell transplants that are done. So for me, it's not as big a leap to do this, but I think it's just sort of where you're coming from, where the patient is coming from. And it may not be for everyone. It is definitely should not be for everyone, but for some patients, it might be something at least to hear about.

So I when I talk to people about stem cell transplantation, I always mention allogeneic transplantation. But that doesn't mean that I think that that's the best thing for them to do. But it's it's informing the patient about what are the choices that are out there. That's the important thing because they need to know so they can pick wisely.