Dr. Martin on Determining Transplant Eligibility in Multiple Myeloma

Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, discusses factors that can inform transplant eligibility in multiple myeloma.

A functional assessment can be indicative of whether a patient can undergo transplant, says Martin. Patients who can undergo a transplant should be able to walk up a flight of stairs or walk a short distance, such as between a few telephone poles, without stopping, Martin explains.

Additionally, patients on oxygen, those whose ejection fraction is less than 40%, or those with active symptoms of congestive heart failure or recent myocardial infarction are likely not candidates for transplant, Martin says. Patients with severe chronic obstructive pulmonary disease or diffusing capacity of the lungs for carbon monoxide less than 40% are also likely transplant ineligible, Martin says.

It is critical to determine transplant eligibility based on these cardiopulmonary and functional criteria because patients need to be able to survive post-transplant complications, such as sepsis, where their heart may need to overcompensate, concludes Martin.