Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study
Abstarct: Introduction: The treatment of elderly multiple myeloma (MM) patients with autologous stem cell transplantation (ASCT) is a controversial procedure. Most clinical trials evaluating the safety and efficacy of ASCT have primarily included patients younger than 65 years. Design and methods:...
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Elsevier
2024-12-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137923001694 |
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| author | Cristian Maximiliano Seehaus Natalia Schutz Erika Brulc Gonzalo Ferini Jorge Arbelbide Dorotea Fantl Ana Lisa Basquiera |
| author_facet | Cristian Maximiliano Seehaus Natalia Schutz Erika Brulc Gonzalo Ferini Jorge Arbelbide Dorotea Fantl Ana Lisa Basquiera |
| author_sort | Cristian Maximiliano Seehaus |
| collection | DOAJ |
| description | Abstarct: Introduction: The treatment of elderly multiple myeloma (MM) patients with autologous stem cell transplantation (ASCT) is a controversial procedure. Most clinical trials evaluating the safety and efficacy of ASCT have primarily included patients younger than 65 years. Design and methods: This was a retrospective analysis of patients with MM who underwent ASCT between 2008 and 2018. Patients at or over 65 years were compared with patients under 65 years. We analyzed treatment-related mortality (TRM), response rate, progression-free survival (PFS) and overall survival (OS). Results: Two hundred and twenty-one patients were included: 50 patients at or over 65 years, (median age 68 years), including 7 patients over 70 years and 151 patients under 65 years, (median age 57 years). No differences were found in the neutrophil and platelet engraftment, median days of hospitalization and life support requirement during the hospitalization period for the ASCT. No statistically significant differences were found in the incidence of TRM between both groups at 100 days post-transplant (2% vs. 2.9%, p = 0.322). The ASCT improved complete response and stringent complete response rates (44% vs. 37%, p < 0.001). Survival was not modified by age: after a median follow-up of 53 months, the estimated PFS rates at three years were 63% and 60% (p = 0.88) and the OS rates at five years were 75% and 74% (p = 0.72), respectively. Conclusions: Our data suggest that the ASCT is feasible in selected elderly patients with MM over 65 years of age, achieving response and survival rates similar to those of younger patients. |
| format | Article |
| id | doaj-art-7c2b0d9ec02b4648b7d8f41a2c7e79fc |
| institution | OA Journals |
| issn | 2531-1379 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-7c2b0d9ec02b4648b7d8f41a2c7e79fc2025-08-20T01:57:00ZengElsevierHematology, Transfusion and Cell Therapy2531-13792024-12-0146S13S2010.1016/j.htct.2023.07.012Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world studyCristian Maximiliano Seehaus0Natalia Schutz1Erika Brulc2Gonzalo Ferini3Jorge Arbelbide4Dorotea Fantl5Ana Lisa Basquiera6Corresponding author at: Hematology Department, Hospital Italiano de Buenos Aires, Juan D. Perón 4190 (C1181ACH), Buenos Aires, Argentina.; Hospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaHospital Italiano de Buenos Aires, Buenos Aires, ArgentinaAbstarct: Introduction: The treatment of elderly multiple myeloma (MM) patients with autologous stem cell transplantation (ASCT) is a controversial procedure. Most clinical trials evaluating the safety and efficacy of ASCT have primarily included patients younger than 65 years. Design and methods: This was a retrospective analysis of patients with MM who underwent ASCT between 2008 and 2018. Patients at or over 65 years were compared with patients under 65 years. We analyzed treatment-related mortality (TRM), response rate, progression-free survival (PFS) and overall survival (OS). Results: Two hundred and twenty-one patients were included: 50 patients at or over 65 years, (median age 68 years), including 7 patients over 70 years and 151 patients under 65 years, (median age 57 years). No differences were found in the neutrophil and platelet engraftment, median days of hospitalization and life support requirement during the hospitalization period for the ASCT. No statistically significant differences were found in the incidence of TRM between both groups at 100 days post-transplant (2% vs. 2.9%, p = 0.322). The ASCT improved complete response and stringent complete response rates (44% vs. 37%, p < 0.001). Survival was not modified by age: after a median follow-up of 53 months, the estimated PFS rates at three years were 63% and 60% (p = 0.88) and the OS rates at five years were 75% and 74% (p = 0.72), respectively. Conclusions: Our data suggest that the ASCT is feasible in selected elderly patients with MM over 65 years of age, achieving response and survival rates similar to those of younger patients.http://www.sciencedirect.com/science/article/pii/S2531137923001694Multiple myelomaElderlyAutologous stem cell transplantation |
| spellingShingle | Cristian Maximiliano Seehaus Natalia Schutz Erika Brulc Gonzalo Ferini Jorge Arbelbide Dorotea Fantl Ana Lisa Basquiera Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study Hematology, Transfusion and Cell Therapy Multiple myeloma Elderly Autologous stem cell transplantation |
| title | Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study |
| title_full | Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study |
| title_fullStr | Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study |
| title_full_unstemmed | Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study |
| title_short | Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study |
| title_sort | autologous stem cell transplantation in patients older than 65 years with multiple myeloma a real world study |
| topic | Multiple myeloma Elderly Autologous stem cell transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2531137923001694 |
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