Leveraging minimal residual disease to reassess autologous hematopoietic cell transplantation in multiple myeloma

While the treatment landscape of multiple myeloma has evolved and expanded over the past decade, autologous hematopoietic cell transplantation remains an integral part of myeloma therapy. The availability of sensitive minimal residual disease (MRD) testing has allowed us to characterize the depth of response beyond traditional response assessment. It also provides an exceptional platform to rapidly study the benefit of each intervention and systemically appraise its incremental benefit. While relatively early in its development as a decision-making tool and faced with challenges such as standardization, it is prime time for MRD testing. The continued incorporation of MRD based endpoints into clinical trials and ultimately, into clinical practice, will result in individualized treatment strategies tailored to each patient resulting in minimum necessary treatment to obtain sustained disease control and long-term survival.