Autologous stem cell transplantation in multiple myeloma patients <60 vs ≥60 years of age Journal Article
| Authors: | Reece, D. E.; Bredeson, C.; Pérez, W. S.; Jagannath, S.; Zhang, M. J.; Ballen, K. K.; Elfenbein, G. J.; Freytes, C. O.; Gale, R. P.; Gertz, M. A.; Gibson, J.; Giralt, S. A.; Keating, A.; Kyle, R. A.; Maharaj, D.; Marcellus, D.; McCarthy, P. L.; Milone, G. A.; Nimer, S. D.; Pavlovsky, S.; To, L. B.; Weisdorf, D. J.; Wiernik, P. H.; Wingard, J. R.; Vesole, D. H. |
| Article Title: | Autologous stem cell transplantation in multiple myeloma patients <60 vs ≥60 years of age |
| Abstract: | 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. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; aged; disease-free survival; middle aged; survival analysis; osteolysis; survival rate; retrospective studies; major clinical study; busulfan; prednisone; cancer recurrence; doxorubicin; cancer risk; alpha interferon; cancer staging; recurrence risk; carboplatin; multiple myeloma; etoposide; cyclophosphamide; dexamethasone; melphalan; vincristine; age factors; cancer mortality; thiotepa; groups by age; risk assessment; confidence interval; cancer regression; whole body radiation; registries; statistical analysis; statistical significance; drug response; graft versus host reaction; transplantation conditioning; nitrosourea; multivariate analysis; beta 2 microglobulin; peripheral blood stem cell transplantation; transplantation, autologous; autologous hematopoietic stem cell transplantation; north america; kruskal wallis test; older patients; autologous transplantation; south america; life tables; humans; prognosis; human; male; female; priority journal; article |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 32 |
| Issue: | 12 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2003-12-02 |
| Start Page: | 1135 |
| End Page: | 1143 |
| Language: | English |
| DOI: | 10.1038/sj.bmt.1704288 |
| PUBMED: | 14647267 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
