Counterpoint: Routine Use of Autologous Stem Cell Transplantation in Multiple Myeloma.

Multiagent induction chemotherapy leads to high response rates in multiple myeloma. The phase III Southwest Oncology Group trial involving 525 patients established lenalidomide, bortezomib, and dexamethasone (RVD) as a preferred induction regimen; in this trial, RVD demonstrated an overall response rate of 81.5%, with 15.7% of responses complete responses (CR), and 27.8% very good partial responses (VGPR).[1] Nonetheless, autologous stem cell transplantation (ASCT) still is and will remain a mainstay of therapy, with 6,300 transplants done in the United States for myeloma in 2013.[2] Phase III trials continue to support the use of high-dose chemotherapy over conventional therapy, even with novel agents.