High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma

T. M. Wildes, J. D. Finney, M. Fiala, F. Gao, R. Vij, K. Stockerl-Goldstein, K. R. Carson, Joseph R Mikhael, G. Colditz

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Randomized trials showing that high-dose therapy with autologous stem cell transplant (ASCT) improved the overall survival (OS) in multiple myeloma (MM) excluded patients over age 65. To compare the outcomes of older adults with MM who underwent ASCT with non-transplant strategies, we identified 146 patients aged 65-77 with newly diagnosed MM seen in the Washington University School of Medicine from 2000 to 2010. Survival among patients who did (N=62) versus did not (N=84) undergo ASCT was compared using Cox proportional hazards modeling, controlling for comorbidities, Eastern Cooperative Oncology Group performance status (PS) and the propensity to undergo ASCT. Median age was 68 years (range 65-77). PS and comorbidities did not differ significantly between those who did versus those who did not undergo ASCT. Median OS was significantly longer in patients who underwent ASCT than in those who did not (median 56.0 months (95% confidence intervals (CIs) 49.1-65.4) versus 33.1 months (24.3-43.1), P=0.004). Adjusting for PS, comorbidities, Durie-Salmon stage and the propensity to undergo ASCT, ASCT was associated with superior OS (HR for mortality 0.52 (95% CI 0.30-0.91), P=0.02). In a cohort of older adults with MM, undergoing ASCT was associated with a nearly 50% lower mortality, after controlling for PS, comorbidities, stage and the propensity to undergo ASCT.

Original languageEnglish (US)
Pages (from-to)1075-1082
Number of pages8
JournalBone Marrow Transplantation
Volume50
Issue number8
DOIs
StatePublished - Aug 8 2015

Fingerprint

Multiple Myeloma
Stem Cells
Transplants
Comorbidity
Therapeutics
Survival
Confidence Intervals
Mortality
Salmon
Medicine

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Wildes, T. M., Finney, J. D., Fiala, M., Gao, F., Vij, R., Stockerl-Goldstein, K., ... Colditz, G. (2015). High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma. Bone Marrow Transplantation, 50(8), 1075-1082. https://doi.org/10.1038/bmt.2015.106

High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma. / Wildes, T. M.; Finney, J. D.; Fiala, M.; Gao, F.; Vij, R.; Stockerl-Goldstein, K.; Carson, K. R.; Mikhael, Joseph R; Colditz, G.

In: Bone Marrow Transplantation, Vol. 50, No. 8, 08.08.2015, p. 1075-1082.

Research output: Contribution to journalArticle

Wildes, TM, Finney, JD, Fiala, M, Gao, F, Vij, R, Stockerl-Goldstein, K, Carson, KR, Mikhael, JR & Colditz, G 2015, 'High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma', Bone Marrow Transplantation, vol. 50, no. 8, pp. 1075-1082. https://doi.org/10.1038/bmt.2015.106
Wildes TM, Finney JD, Fiala M, Gao F, Vij R, Stockerl-Goldstein K et al. High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma. Bone Marrow Transplantation. 2015 Aug 8;50(8):1075-1082. https://doi.org/10.1038/bmt.2015.106
Wildes, T. M. ; Finney, J. D. ; Fiala, M. ; Gao, F. ; Vij, R. ; Stockerl-Goldstein, K. ; Carson, K. R. ; Mikhael, Joseph R ; Colditz, G. / High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma. In: Bone Marrow Transplantation. 2015 ; Vol. 50, No. 8. pp. 1075-1082.
@article{c87d6a6eb4244abcbc971cc905746014,
title = "High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma",
abstract = "Randomized trials showing that high-dose therapy with autologous stem cell transplant (ASCT) improved the overall survival (OS) in multiple myeloma (MM) excluded patients over age 65. To compare the outcomes of older adults with MM who underwent ASCT with non-transplant strategies, we identified 146 patients aged 65-77 with newly diagnosed MM seen in the Washington University School of Medicine from 2000 to 2010. Survival among patients who did (N=62) versus did not (N=84) undergo ASCT was compared using Cox proportional hazards modeling, controlling for comorbidities, Eastern Cooperative Oncology Group performance status (PS) and the propensity to undergo ASCT. Median age was 68 years (range 65-77). PS and comorbidities did not differ significantly between those who did versus those who did not undergo ASCT. Median OS was significantly longer in patients who underwent ASCT than in those who did not (median 56.0 months (95{\%} confidence intervals (CIs) 49.1-65.4) versus 33.1 months (24.3-43.1), P=0.004). Adjusting for PS, comorbidities, Durie-Salmon stage and the propensity to undergo ASCT, ASCT was associated with superior OS (HR for mortality 0.52 (95{\%} CI 0.30-0.91), P=0.02). In a cohort of older adults with MM, undergoing ASCT was associated with a nearly 50{\%} lower mortality, after controlling for PS, comorbidities, stage and the propensity to undergo ASCT.",
author = "Wildes, {T. M.} and Finney, {J. D.} and M. Fiala and F. Gao and R. Vij and K. Stockerl-Goldstein and Carson, {K. R.} and Mikhael, {Joseph R} and G. Colditz",
year = "2015",
month = "8",
day = "8",
doi = "10.1038/bmt.2015.106",
language = "English (US)",
volume = "50",
pages = "1075--1082",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "8",

}

TY - JOUR

T1 - High-dose therapy and autologous stem cell transplant in older adults with multiple myeloma

AU - Wildes, T. M.

AU - Finney, J. D.

AU - Fiala, M.

AU - Gao, F.

AU - Vij, R.

AU - Stockerl-Goldstein, K.

AU - Carson, K. R.

AU - Mikhael, Joseph R

AU - Colditz, G.

PY - 2015/8/8

Y1 - 2015/8/8

N2 - Randomized trials showing that high-dose therapy with autologous stem cell transplant (ASCT) improved the overall survival (OS) in multiple myeloma (MM) excluded patients over age 65. To compare the outcomes of older adults with MM who underwent ASCT with non-transplant strategies, we identified 146 patients aged 65-77 with newly diagnosed MM seen in the Washington University School of Medicine from 2000 to 2010. Survival among patients who did (N=62) versus did not (N=84) undergo ASCT was compared using Cox proportional hazards modeling, controlling for comorbidities, Eastern Cooperative Oncology Group performance status (PS) and the propensity to undergo ASCT. Median age was 68 years (range 65-77). PS and comorbidities did not differ significantly between those who did versus those who did not undergo ASCT. Median OS was significantly longer in patients who underwent ASCT than in those who did not (median 56.0 months (95% confidence intervals (CIs) 49.1-65.4) versus 33.1 months (24.3-43.1), P=0.004). Adjusting for PS, comorbidities, Durie-Salmon stage and the propensity to undergo ASCT, ASCT was associated with superior OS (HR for mortality 0.52 (95% CI 0.30-0.91), P=0.02). In a cohort of older adults with MM, undergoing ASCT was associated with a nearly 50% lower mortality, after controlling for PS, comorbidities, stage and the propensity to undergo ASCT.

AB - Randomized trials showing that high-dose therapy with autologous stem cell transplant (ASCT) improved the overall survival (OS) in multiple myeloma (MM) excluded patients over age 65. To compare the outcomes of older adults with MM who underwent ASCT with non-transplant strategies, we identified 146 patients aged 65-77 with newly diagnosed MM seen in the Washington University School of Medicine from 2000 to 2010. Survival among patients who did (N=62) versus did not (N=84) undergo ASCT was compared using Cox proportional hazards modeling, controlling for comorbidities, Eastern Cooperative Oncology Group performance status (PS) and the propensity to undergo ASCT. Median age was 68 years (range 65-77). PS and comorbidities did not differ significantly between those who did versus those who did not undergo ASCT. Median OS was significantly longer in patients who underwent ASCT than in those who did not (median 56.0 months (95% confidence intervals (CIs) 49.1-65.4) versus 33.1 months (24.3-43.1), P=0.004). Adjusting for PS, comorbidities, Durie-Salmon stage and the propensity to undergo ASCT, ASCT was associated with superior OS (HR for mortality 0.52 (95% CI 0.30-0.91), P=0.02). In a cohort of older adults with MM, undergoing ASCT was associated with a nearly 50% lower mortality, after controlling for PS, comorbidities, stage and the propensity to undergo ASCT.

UR - http://www.scopus.com/inward/record.url?scp=84938956132&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938956132&partnerID=8YFLogxK

U2 - 10.1038/bmt.2015.106

DO - 10.1038/bmt.2015.106

M3 - Article

C2 - 25961765

AN - SCOPUS:84938956132

VL - 50

SP - 1075

EP - 1082

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 8

ER -