Autologous stem cell transplant for multiple myeloma patients 70 years or older

E. Muchtar, D. Dingli, S. Kumar, F. K. Buadi, A. Dispenzieri, S. R. Hayman, R. C. Wolf, D. A. Gastineau, R. Chakraborty, W. J. Hogan, N. Leung, P. Kapoor, M. Q. Lacy, S. V. Rajkumar, M. A. Gertz

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Autologous stem cell transplant (Auto-SCT) is increasingly used in older patients with multiple myeloma (MM), despite lack of phase 3 trials in this age-defined population. For 207 consecutive MM patients who underwent Auto-SCT and were 70 years or older at transplant (study cohort), data were analyzed and compared with a younger cohort (1764 Auto-SCT patients <70 years old). The proportion of Auto-SCT in the older patients increased from 7.8% of all transplants in 1998-2006 to 12.9% in 2007-2015. Sixty percent of patients required stem cell mobilization with chemotherapy or plerixafor. Full-dose melphalan conditioning was given to 55% of the older patients compared with 93% of the younger patients (P<0.001). Older patients were more likely to be hospitalized (64% vs 55%; P=0.01), but hospitalization duration was comparable. For newly diagnosed patients, median PFS was 33.5 months for the older cohort and 33.8 months for the younger cohort (P=0.91), and median overall survival was 6.1 and 7.8 years, respectively (P=0.11). Presumably, a smaller fraction of patients, age 70-76, is selected for Auto-SCT, but the benefits are comparable to those seen for younger patients. Reduced-dose melphalan was given to approximately half the patients to avoid excessive toxicity.

Original languageEnglish (US)
Pages (from-to)1449-1455
Number of pages7
JournalBone Marrow Transplantation
Volume51
Issue number11
DOIs
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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