The role of stem cell transplantation in the modern management of multiple myeloma

ASCT has been standard of care in the treatment of NDMM for transplant-eligible patients for over three decades. With the advent of modern induction regimens and immunotherapies, treatment paradigms are evolving rapidly, challenging the current role, timing, and necessity of ASCT. This review explores the contemporary role of ASCT in NDMM. Despite the promise of immunotherapy, the current evidence continues to support ASCT as a consolidative therapy that remains highly effective, accessible, and cost-efficient, particularly when integrated with modern therapeutics and MRD-driven algorithms.