Autologous HCT Similarly Effective in Older Patients With Myeloma vs Younger Patients

Older patients with multiple myeloma who underwent autologous hematopoietic cell transplantation (HCT) achieved similar outcomes as younger patients in terms of progression-free survival but not overall survival, a study presented at the BMT Tandem Meetings 2016 in Honolulu, HI, has shown.¹

Although high-dose chemotherapy with autologous HCT is a standard of care for patients with multiple myeloma, the efficacy and safety of this approach in older patients remains unclear. In addition, patients 70 years and older have historically denied autologous HCT based on age alone. Therefore, researchers at Duke University Medical Center in Durham, NC, sought to evaluate the association of age with post-HCT clinical outcomes.

For the study, researchers retrospectively analyzed data from 305 patients who underwent autologous HCT within 2 years of multiple myeloma diagnosis and received melphalan-only preparation at their institution.

Results showed that at a median follow-up of 3.5 years, 5-year progression-free survival in older patients was non-inferior to that in younger patients (HR, 0.940; 95% CI, 0.860 – 1.025; P = .006). In contrast, researchers found that 5-year overall survival was worse in older patients than in younger patients (HR, 1.058; 95% CI, 0.942 – 1.189; P = .55).

The study also demonstrated that the overall incidence of treatment-related death was 2%, and rates of unexpected hospitalization during HCT were similar between patients 70 years and older and those younger than 70 (27% vs 32%, respectively; P=.61).

The authors concluded that natural death or comorbidities may have contributed to the lower overall survival rate in older patients.

Reference

1. Huang L-W, Bacon W, Cirrincione C, et al. Efficacy of autologous stem cell transplantation in older multiple myeloma patients. Poster presented at: BMT Tandem Meetings 2016; February 18-22, 2016; Honolulu, HI.