Efficacy and safety of autologous stem cell transplantation in patients aged ≥ 65 years with multiple myeloma in the era of novel agents.

Abstract

Clinical trials evaluating the role of autologous hematopoietic stem cell transplantation (auto-HCT) in multiple myeloma have mostly included patients aged <65 years. Therefore, this study was aimed to evaluate the efficacy and safety of auto-HCT in elderly patients with multiple myeloma in the era of novel agents. We retrospectively analyzed 2056 patients with multiple myeloma, who underwent auto-HCT in 2007-2014 (287 were aged ≥65 years). We evaluated the 100-day treatment-related mortality (TRM) and overall survival (OS) in two groups; elderly patients ( ≥65 years) who underwent auto-HCT compared with younger patients ( <65 years). In the propensity score-matched-pair analysis used to adjust for possible selection bias, the incidence of 100-day TRM between patients aged <65 (0.4%; 95% confidence interval [CI]: 0.0-2.0%) and ≥65 years (1.2%; 95% CI: 0.3-3.1%) showed no statistically significant difference (p = 0.31). The probability of the 5-year OS after transplantation in those aged <65 (62.5%; 95% CI: 58.6-66.1%) and ≥65 (63.5%; 95% CI: 52.2-72.7%) years was also not significantly different (p = 0.56). This study showed that the safety and efficacy of auto-HCT in elderly patients with multiple myeloma in the era of novel agents compared with younger patients were similar.

• Authors: Shohei Mizuno, Koji Kawamura, Ichiro Hanamura, Kazutaka Sunami, Takehiko Mori, Fumihiko Nakamura, Shinsuke Iida, Hideyuki Nakazawa, Masanori Makita, Shinichi Kako, Masashi Sawa, Yasunori Ueda, Hiroyuki Takahashi, Yoshinobu Kanda, Tatsuo Ichinohe, Yoshiko Atsuta, Hiroyuki Takamatsu, Akiyoshi Takami
• Journal: Bone marrow transplantation (Bone Marrow Transplant) Vol. 54 Issue 10 Pg. 1595-1604 (10 2019) ISSN: 1476-5365 [Electronic] England
• PMID: 30783208 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Female
• Humans
• Male
• Multiple Myeloma (pathology, therapy)
• Transplantation, Autologous (methods)