Patients with newly diagnosed multiple myeloma and high-risk cytogenetics should be offered upfront rather than delayed high-dose therapy consolidation, a new analysis suggests.

According to US researchers, early autologous stem cell transplantation leads to favourable overall survival rates in high-risk patients receiving induction therapy containing a proteasome inhibitor or an immunomodulatory drug, or both.

Conversely, delaying high-dose therapy in this setting “incurs the risk of omitting an effective treatment modality, with an adverse impact on survival”, they said.

In a meta-analysis of six randomised controlled trials, clinicians pooled data from nearly 3000 adults (median age 56-60) with newly diagnosed multiple myeloma to compare the benefits of high-dose versus standard dose therapy.