1. Autologous stem cell transplantation in multiple myeloma patients <60 vs >/=60 years of age.
- Author
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Reece DE, Bredeson C, Pérez WS, Jagannath S, Zhang MJ, Ballen KK, Elfenbein GJ, Freytes CO, Gale RP, Gertz MA, Gibson J, Giralt SA, Keating A, Kyle RA, Maharaj D, Marcellus D, McCarthy PL, Milone GA, Nimer SD, Pavlovsky S, To LB, Weisdorf DJ, Wiernik PH, Wingard JR, and Vesole DH
- Subjects
- Adult, Age Factors, Aged, Disease-Free Survival, Female, Humans, Life Tables, Male, Middle Aged, Multiple Myeloma mortality, North America, Osteolysis etiology, Registries, Retrospective Studies, South America, Survival Analysis, Transplantation Conditioning, Transplantation, Autologous, Treatment Outcome, Multiple Myeloma therapy, Peripheral Blood Stem Cell Transplantation mortality, Peripheral Blood Stem Cell Transplantation statistics & numerical data
- 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 beta(2)-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.
- Published
- 2003
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