Autologous stem cell transplantation in elderly patients with multiple myeloma: evaluation of its safety and efficacy

Abstract

Administering high-dose chemotherapy (HDCT) with melphalan to elderly myeloma patients represents a challenge with respect to achieving therapeutic efficacy whilst avoiding significant toxicity. We analyzed safety and efficacy of HDCT in 61 elderly myeloma patients older than 65 years, including 12 patients ≥70 years, and compared them with 237 MM patients below 65 years treated in the same period. We observed no differences in the time until neutrophil recovery, infection rate, and treatment related mortality until 100 days after ASCT. Furthermore, higher age was not associated with inferior progression-free and overall survival at 1 and 2 years after ASCT. However, MM patients older than 70 years had a longer duration of hospitalization (26 vs. 20 days; p= .0001) and a longer time until platelet recovery >20G/L (20 vs. 13 days; p= .0007). Our data suggest that HDCT with ASCT is feasible, safe and effective in MM patients older than 65 years.

Keywords:

• Myeloma
• elderly
• high-dose chemotherapy
• autologous
• transplant
• stem cell
• survival
• prognosis
• safety
• efficacy

Acknowledgments

The authors wish to thank Irene Briner, Marion Bleckmann, Barbara Muster and Gaby Fahrni for help with data collection, and the apheresis, flow cytometry and stem cell laboratory teams for documentation of data relevant for this study. This work was supported by grants from the Krebsliga Bern (to TP), and from the EMPIRIS Foundation/Ursula-Hecht-Fonds (to TP).

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2016.1233542.