TY - JOUR
T1 - Older Patients with Myeloma Derive Similar Benefit from Autologous Transplantation
AU - Sharma, Manish
AU - Zhang, Mei-Jie
AU - Zhong, Xiaobo
AU - Abidi, Muneer H.
AU - Akpek, Goerguen
AU - Bacher, Ulrike
AU - Callander, Natalie S.
AU - Dispenzieri, Angela
AU - Freytes, Cesar O.
AU - Fung, Henry C.
AU - Gale, Robert Peter
AU - Gasparetto, Cristina
AU - Gibson, John
AU - Holmberg, Leona A.
AU - Kindwall-Keller, Tamila L.
AU - Klumpp, Thomas R.
AU - Krishnan, Amrita Y.
AU - Landau, Heather J.
AU - Lazarus, Hillard M.
AU - Lonial, Sagar
AU - Maiolino, Angelo
AU - Marks, David I.
AU - Mehta, Paulette
AU - Med, Joseph R. Mikhael
AU - Nishihori, Taiga
AU - Olsson, Richard
AU - Ramanathan, Muthalagu
AU - Roy, Vivek
AU - Savani, Bipin N.
AU - Schouten, Harry C.
AU - Scott, Emma
AU - Tay, Jason
AU - To, Luen Bik
AU - Vesole, David H.
AU - Vogl, Dan T.
AU - Hari, Parameswaran
PY - 2014/11
Y1 - 2014/11
N2 - Autologous hematopoietic cell transplantation (AHCT) for plasma cell myeloma is performed less often in people >70 years old than in people ?70 years old. We analyzed 11,430 AHCT recipients for plasma cell myeloma prospectively reported to the Center for International Blood and Marrow Transplant Research between 2008 and 2011, representing the majority of US AHCT activity during this period. Survival (OS) was compared in 3 cohorts: ages 18 to 59 years (n = 5818), 60 to 69 years (n = 4666), and >70 years (n = 946). Median OS was not reached for any cohort. In multivariate analysis, increasing age was associated with mortality (P = .0006). Myeloma-specific mortality was similar among cohorts at 12%, indicating an age-related effect on nonmyeloma mortality. Analyses were performed in a representative subgroup comparing relapse rate, progression-free survival (PFS), and nonrelapse mortality (NRM). One-year NRM was 0% for age >70 years and 2% for other ages (P = not significant). The three-year relapse rate was 56% in age 18 to 59 years, 61% in age 60 to 69 years, and 63% age >70 (P = not significant). Three-year PFS was similar at 42% in age 18 to 59 years, 38% in age 60 to 69 years, and 33% in age >70 years (P = not significant). Postrelapse survival was significantly worse for the older cohort (P = .03). Older subjects selected for AHCT derived similar antimyeloma benefit without worse NRM, relapse rate, or PFS. American Society for Blood and Marrow Transplantation.
AB - Autologous hematopoietic cell transplantation (AHCT) for plasma cell myeloma is performed less often in people >70 years old than in people ?70 years old. We analyzed 11,430 AHCT recipients for plasma cell myeloma prospectively reported to the Center for International Blood and Marrow Transplant Research between 2008 and 2011, representing the majority of US AHCT activity during this period. Survival (OS) was compared in 3 cohorts: ages 18 to 59 years (n = 5818), 60 to 69 years (n = 4666), and >70 years (n = 946). Median OS was not reached for any cohort. In multivariate analysis, increasing age was associated with mortality (P = .0006). Myeloma-specific mortality was similar among cohorts at 12%, indicating an age-related effect on nonmyeloma mortality. Analyses were performed in a representative subgroup comparing relapse rate, progression-free survival (PFS), and nonrelapse mortality (NRM). One-year NRM was 0% for age >70 years and 2% for other ages (P = not significant). The three-year relapse rate was 56% in age 18 to 59 years, 61% in age 60 to 69 years, and 63% age >70 (P = not significant). Three-year PFS was similar at 42% in age 18 to 59 years, 38% in age 60 to 69 years, and 33% in age >70 years (P = not significant). Postrelapse survival was significantly worse for the older cohort (P = .03). Older subjects selected for AHCT derived similar antimyeloma benefit without worse NRM, relapse rate, or PFS. American Society for Blood and Marrow Transplantation.
KW - Myeloma
KW - Older patients
KW - Autologous transplantation
U2 - 10.1016/j.bbmt.2014.07.013
DO - 10.1016/j.bbmt.2014.07.013
M3 - Article
C2 - 25046833
SN - 1083-8791
VL - 20
SP - 1796
EP - 1803
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 11
ER -