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.
Bibliographical noteFunding Information:
Genentech, Inc.; GlaxoSmithKline, Inc.; Human Genome Sciences; ICN Pharmaceuticals, Inc.; IDEC Pharmaceuticals Corporation; IntraBiotics Pharmaceuticals; Kettering Family Foundation; Kirin Brewery Company; Robert J Kleberg, Jr and Helen C Kleberg Foundation; LifeTrac/Allianz; Eli Lilly and Company; The Liposome Company; Nada and Herbert P Mahler Charities; Market Certitude, LLC; Mayer Ventures; MedImmune, Inc.; Merck & Co., Inc.; Milliman & Robertson, Inc.; Milstein Family Foundation; The Greater Milwaukee Foundation/Elsa Schoeneich Research Fund; NeoRx; Nexell Therapeutics; Novartis Pharmaceuticals; Orphan Medical; Ortho Biotech, Inc.; John Oster Family Foundation; Osiris Therapeutics, Inc.; Pfizer US Pharmaceuticals; Pharmacia Corporation; Pharmametrics GmbH; Principal Life Insurance Company; Protein Design Labs, Inc.; Response Oncology, Inc.; RGK Foundation; Roche Laboratories, Inc.; SangStat; Schering AG; Schering Oncology/Biotech; Stackner Family Foundation; The Starr Foundation; SuperGen, Inc.; TheraTechnologies, Inc.; Unicare Life & Health Insurance; Wyeth/Genetics Institute and ZymoGenetics, Inc. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.
This work was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute, and grants from Abgenix, Inc.; AmCell Corporation; American Cancer Society; American Society of Clinical Oncology; Amgen, Inc.; Anonymous; Aventis Pharmaceuticals; Berlex Laboratories; BioTransplant, Incorporated; Blue Cross and Blue Shield Association; Lynde and Harry Bradley Foundation; Bristol-Myers Squibb Oncology; CelMed Biosciences; Center for Advanced Studies in Leukemia; Cerus Corporation; Chimeric Therapies; Chiron Therapeutics; Eleanor Naylor Dana Charitable Trust; Deborah J Dearholt Memorial Fund; Edwards Lifesciences RMI; Empire Blue Cross Blue Shield; Fujisawa Healthcare, Inc.; Gambro BCT, Inc.;
- Autologous transplantation
- Multiple myeloma
- Older patients