Autologous stem cell transplantation in multiple myeloma patients <60 vs ≥60 years of age

D. E. Reece, C. Bredeson, W. S. Pérez, S. Jagannath, M. J. Zhang, K. K. Ballen, G. J. Elfenbein, C. O. Freytes, R. P. Gale, M. A. Gertz, J. Gibson, S. A. Giralt, A. Keating, R. A. Kyle, D. Maharaj, D. Marcellus, P. L. McCarthy, G. A. Milone, S. D. Nimer, S. PavlovskyL. B. To, D. J. Weisdorf, P. H. Wiernik, J. R. Wingard, D. H. Vesole

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

The role of autologous stem cell transplantation (AuSCT) in older multiple myeloma patients is unclear. Using data from the Autologous Blood and Marrow Transplant Registry, we compared the outcome of 110 patients ≥the age of 60 (median 63; range 60-73) years, undergoing AuSCT with that of 382 patients <60 (median 52; range 30-59) years. The two groups were similar except that older patients had a higher β2-microglobulin level at diagnosis (P=0.016) and fewer had lytic lesions (P=0.007). Day 100 mortality was 6% (95% confidence interval 4-9) and 1-year treatment-related mortality (TRM) was 9% (6-13) in patients <60 years, compared with 5% (2-10) and 8% (4-14), respectively, in patients ≥60 years. The relapse rate, progression-free survival (PFS) and overall survival (OS) in the two groups were also similar. Multivariate analysis of all patients identified only an interval from diagnosis to AuSCT > 12 months and the use of two prior chemotherapy regimens within 6 months of AuSCT as adverse prognostic factors. Our results indicate that AuSCT can be safely performed in selected older patients: the best results were observed in patients undergoing AuSCT relatively early in their disease course.

Original languageEnglish (US)
Pages (from-to)1135-1143
Number of pages9
JournalBone Marrow Transplantation
Volume32
Issue number12
DOIs
StatePublished - Dec 1 2003
Externally publishedYes

Keywords

  • Autologous transplantation
  • Multiple myeloma
  • Older patients

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Reece, D. E., Bredeson, C., Pérez, W. S., Jagannath, S., Zhang, M. J., Ballen, K. K., Elfenbein, G. J., Freytes, C. O., Gale, R. P., Gertz, M. A., Gibson, J., Giralt, S. A., Keating, A., Kyle, R. A., Maharaj, D., Marcellus, D., McCarthy, P. L., Milone, G. A., Nimer, S. D., ... Vesole, D. H. (2003). Autologous stem cell transplantation in multiple myeloma patients <60 vs ≥60 years of age. Bone Marrow Transplantation, 32(12), 1135-1143. https://doi.org/10.1038/sj.bmt.1704288