Autologous stem cell transplantation in patients older than 65 years with multiple myeloma: a real-world study.

Cristian Maximiliano Seehaus, Natalia Schutz, Erika Brulc, Gonzalo Ferini, Jorge Arbelbide, Dorotea Fantl, Ana Lisa Basquiera
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Abstract

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.

自体干细胞移植治疗65岁以上多发性骨髓瘤患者:一项真实世界的研究。
引言:自体干细胞移植(ASCT)治疗老年多发性骨髓瘤(MM)患者是一项有争议的手术。大多数评估ASCT安全性和有效性的临床试验主要包括65岁以下的患者。设计和方法:这是对2008年至2018年间接受ASCT的MM患者的回顾性分析。将65岁或65岁以上的患者与65岁以下的患者进行比较。我们分析了治疗相关死亡率(TRM)、有效率、无进展生存期(PFS)和总生存期(OS)。ASCT在中性粒细胞和血小板植入、中位住院天数和住院期间的生命支持需求方面没有发现差异。在移植后100天,两组之间的TRM发生率没有发现统计学上的显著差异(2%对2.9%,p=0.322)。ASCT改善了完全缓解率和严格的完全缓解率(44%对37%,p<0.001)。生存率不受年龄的影响:中位随访53个月后,三年的PFS估计率分别为63%和60%(p=0.88),五年的OS估计率分别是75%和74%(p=0.72)。结论:我们的数据表明,ASCT在65岁以上的老年MM患者中是可行的,其疗效和生存率与年轻患者相似。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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