High-dose melphalan supported by autologous transplantation has been the standard of care for eligible patients with newly diagnosed multiple myeloma (MM) for >25 years. Several randomized clinical trials have recently reaffirmed the strong position of transplantation in the era of proteasome inhibitors and immunomodulatory drugs combinations, demonstrating a significant reduction of progression or death in comparison with strategies without transplantation. Immunotherapy is currently changing the paradigm of MM management, and daratumumab is the first-in-class human monoclonal antibody targeting CD38 approved in the setting of newly diagnosed MM. Quadruplets have become the new standard in transplantation programs, but outcomes remain heterogeneous, with various response depth and duration. The development of sensitive and specific tools for disease prognostication allows the consideration of strategies adaptive to dynamic risk. This review discusses the different options available for the treatment of transplantation-eligible patients with MM in frontline setting.

中文翻译：

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我如何治疗符合一线移植条件的多发性骨髓瘤。

自体移植支持的高剂量美法仑已成为符合条件的新诊断多发性骨髓瘤 (MM) 患者的标准治疗超过 25 年。最近几项随机临床试验重申了移植在蛋白酶体抑制剂和免疫调节药物组合时代的强大地位，表明与不进行移植的策略相比，进展或死亡显着减少。免疫疗法目前正在改变 MM 管理的范式，daratumumab 是首个获批用于新诊断 MM 的靶向 CD38 的人源单克隆抗体。四胞胎已成为移植项目的新标准，但结果仍然异质，反应深度和持续时间各不相同。开发用于疾病预测的敏感和特定工具允许考虑适应动态风险的策略。本综述讨论了在一线环境中可用于治疗符合移植条件的 MM 患者的不同选择。