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

doi:10.1016/j.htct.2023.07.012

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

Hematol Transfus Cell Ther. 2023 Sep 5:S2531-1379(23)00169-4. doi: 10.1016/j.htct.2023.07.012. Online ahead of print.

Authors

Cristian Maximiliano Seehaus¹, Natalia Schutz², Erika Brulc², Gonzalo Ferini², Jorge Arbelbide², Dorotea Fantl², Ana Lisa Basquiera²

Affiliations

¹ Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: cristian.seehaus@hospitalitaliano.org.ar.
² Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

PMID: 37739860
DOI: 10.1016/j.htct.2023.07.012

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.

Keywords: Autologous stem cell transplantation; Elderly; Multiple myeloma.