Evidence map›Paper›PMID 41482478›Full record

SynthesisBritish journal of haematology2026

Inconsistent definitions of transplant ineligibility in multiple myeloma: A systematic review.

Karun Neupane, Mitch Singstock, Darshi Shah, Riyasha Dahal, Hira Mian, Febe Smith, Rajshekhar Chakraborty, Samer Al Hadidi, Maria Mainou, Ariel Grajales-Cruz and 6 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of haematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Karun NeupaneDepartment of Hematology and Oncology, Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA.ORCID https://orcid.org/0000-0001-7950-5287
Mitch SingstockDepartment of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Darshi ShahRenaissance School of Medicine at Stony Brook University, Stony Brook, New York, USA.
Riyasha DahalDepartment of Internal Medicine, Manatee Memorial Hospital, Bradenton, Florida, USA.
Hira MianMcMaster University, Hamilton, Ontario, Canada.
Febe SmithAmsterdam University Medical Center, Amsterdam, The Netherlands.
Rajshekhar ChakrabortyColumbia University Medical Center, New York, New York, USA.
Samer Al HadidiUniversity of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID https://orcid.org/0000-0003-4297-8042
Maria MainouClinical Research and Evidence Based Medicine Unit, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Ariel Grajales-CruzDepartment of Hematology and Oncology, Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA.
Syeda Mahrukh Hussnain NaqviDepartment of Biostatistics and Bioinformatics, Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA.
Kenneth H ShainDepartment of Hematology and Oncology, Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA.
Aaron GoodmanMountainView Hospital, Las Vegas, Nevada, USA.
Luciano J CostaO'Neal Comprehensive Cancer Center, Department of Hematology and Oncology, University of Alabama, Birmingham, Alabama, USA.
Muzaffar QazilbashMD Anderson Cancer Center, Houston, Texas, USA.
Ghulam Rehman MohyuddinDivision of Hematology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.ORCID https://orcid.org/0000-0001-6464-783X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

High-dose melphalan followed by autologous stem cell transplantation (ASCT) is the standard of care for eligible patients with newly diagnosed multiple myeloma (NDMM). A substantial proportion of patients are deemed ineligible for ASCT due to age, comorbidities, performance status and/or frailty. Criteria defining transplant ineligibility remain inconsistent and poorly characterized. We conducted a systematic review that assessed phase II, III and IV randomized controlled trials (RCTs) through March 2025. We included a total of 55 studies that enrolled transplant-ineligible/deferred NDMM patients. Among 55 transplant-ineligible trials, only 47% explicitly defined ineligibility criteria. Of these, 44% of trials used age as a cut-off with/without other criteria. Only two studies explicitly specified which comorbidities constituted transplant ineligibility. When age was utilized as a cut-off, age ≥65 was the most commonly used cut-off. The median age of participants in these trials ranged from 62 years to 78.5 years and showed a trend upwards over time (p = 0.1388). Performance status of enrolled patients was reported inconsistently. Frailty tools were reported in 22% of studies. RCTs enrolling transplant-ineligible patients with NDMM demonstrated considerable heterogeneity in defining ineligibility. While the decision to pursue ASCT remains individualized, the absence of evidence-based definitions of transplant ineligibility complicates research interpretation and clinical decision-making.

Indexed as

Hematopoietic Stem Cell TransplantationMultiple MyelomaPatient SelectionAgedAge FactorsHumansMiddle AgedRandomized Controlled Trials as TopicTransplantation, Autologousautologous stem cell transplantfrailtymyelomanewly diagnosed multiple myelomatransplant ineligibility

Identifiers

PMID41482478
PMCPMC12995538

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.