Older Patients with Myeloma Derive Similar Benefit from Autologous Transplantation

Manish Sharma, Mei-Jie Zhang, Xiaobo Zhong, Muneer H. Abidi, Goerguen Akpek, Ulrike Bacher, Natalie S. Callander, Angela Dispenzieri, Cesar O. Freytes, Henry C. Fung, Robert Peter Gale, Cristina Gasparetto, John Gibson, Leona A. Holmberg, Tamila L. Kindwall-Keller, Thomas R. Klumpp, Amrita Y. Krishnan, Heather J. Landau, Hillard M. Lazarus, Sagar LonialAngelo Maiolino, David I. Marks, Paulette Mehta, Joseph R. Mikhael Med, Taiga Nishihori, Richard Olsson, Muthalagu Ramanathan, Vivek Roy, Bipin N. Savani, Harry C. Schouten, Emma Scott, Jason Tay, Luen Bik To, David H. Vesole, Dan T. Vogl, Parameswaran Hari*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

61 Citations (Web of Science)

Abstract

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.
Original languageEnglish
Pages (from-to)1796-1803
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 2014

Keywords

  • Myeloma
  • Older patients
  • Autologous transplantation

Cite this