A Comparative Study of Autologous Stem Cell Transplantation (ASCT) Versus No ASCT in Newly Diagnosed Multiple Myeloma: A Single-Institution Experience From South India.

Background Multiple myeloma (MM) is a clonal plasma cell malignancy with significant morbidity and mortality. Autologous stem cell transplantation (ASCT) has been a cornerstone in the treatment of newly diagnosed MM, but its role in the era of novel therapeutic agents remains under evaluation. Data from Indian populations are limited, particularly in the context of ASCT outcomes. This study aimed to compare the outcomes of ASCT versus no ASCT in newly diagnosed MM patients treated at a single institution in South India. Methodology A retrospective analysis was conducted among 59 patients diagnosed with MM between 2019 and 2023. In total, 11 patients underwent ASCT, while 48 did not. Patient demographics, treatment details, and outcomes were collected. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Results The median OS for all patients was 35 months. Patients who underwent ASCT had a significantly longer median OS (61 months) compared to those who did not (not reached; p = 0.007). ASCT was associated with improved survival, particularly in patients with favorable prognostic factors such as younger age and lower International Staging System stage. Conclusions ASCT was associated with a significant survival benefit in patients with newly diagnosed MM in our cohort. Despite the emergence of novel agents, ASCT remains a valuable treatment option, particularly in selected patients with good performance status. Larger prospective studies are warranted to further define the role of ASCT in the era of modern therapies in the Indian context.