TY - JOUR
T1 - Evaluation of the feasibility and efficacy of autologous stem cell transplantation in elderly patients with multiple myeloma
AU - Muta, Tsuyoshi
AU - Miyamoto, Toshihiro
AU - Fujisaki, Tomoaki
AU - Ohno, Yuju
AU - Kamimura, Tomohiko
AU - Kato, Koji
AU - Takenaka, Katsuto
AU - Iwasaki, Hiromi
AU - Eto, Tetsuya
AU - Takamatsu, Yasushi
AU - Teshima, Takanori
AU - Akashi, Koichi
PY - 2013
Y1 - 2013
N2 - Objective The feasibility and efficacy of high-dose melphalan (HD-MEL) followed by autologous hema- topoietic stem cell transplantation (auto-SCT) in elderly patients with multiple myeloma (MM) are discussed. Methods We retrospectively analyzed and compared the results of 25 elderly patients (aged 65-76 years, elderly group) and 63 control patients (aged 51-64 years, control group). Many patients received a vincristine and doxorubicin combined with dexamethasone (VAD) regimen (elderly group: 92%, control group: 78%) with autologous peripheral blood stem cells being harvested after the administration of chemotherapy with high-dose cyclophosphamide (elderly group: 72%, control group: 87%). Ten elderly patients received MEL at a dose of 100-120 mg/m2, while 15 patients received MEL at a dose of 180-200 mg/m2. Results Treatment-related deaths occurred in one elderly patient and two younger patients due to infections. The rate of achieving complete response (CR) or very good partial response (VGPR) was 60% in the elderly group and 83% in the control group. Progression-free survival from auto-SCT in the elderly group was similar to that observed in the control group (median 17.1 vs. 20.8 months, p=0.26), with the median overall survival (OS) from auto-SCT being 40.8 months in the former and 72.5 months in the latter group (p=0.07). When calculated from the beginning of induction treatment, the median OS of the elderly group was 47.0 months and the 3-year OS rate was 81%. Conclusion The current study provides evidence for the efficacy of auto-SCT in elderly MM patients. A prospective study of auto-SCT in elderly patients using strict eligibility criteria is required to evaluate the prolongation of survival in the era of novel agents.
AB - Objective The feasibility and efficacy of high-dose melphalan (HD-MEL) followed by autologous hema- topoietic stem cell transplantation (auto-SCT) in elderly patients with multiple myeloma (MM) are discussed. Methods We retrospectively analyzed and compared the results of 25 elderly patients (aged 65-76 years, elderly group) and 63 control patients (aged 51-64 years, control group). Many patients received a vincristine and doxorubicin combined with dexamethasone (VAD) regimen (elderly group: 92%, control group: 78%) with autologous peripheral blood stem cells being harvested after the administration of chemotherapy with high-dose cyclophosphamide (elderly group: 72%, control group: 87%). Ten elderly patients received MEL at a dose of 100-120 mg/m2, while 15 patients received MEL at a dose of 180-200 mg/m2. Results Treatment-related deaths occurred in one elderly patient and two younger patients due to infections. The rate of achieving complete response (CR) or very good partial response (VGPR) was 60% in the elderly group and 83% in the control group. Progression-free survival from auto-SCT in the elderly group was similar to that observed in the control group (median 17.1 vs. 20.8 months, p=0.26), with the median overall survival (OS) from auto-SCT being 40.8 months in the former and 72.5 months in the latter group (p=0.07). When calculated from the beginning of induction treatment, the median OS of the elderly group was 47.0 months and the 3-year OS rate was 81%. Conclusion The current study provides evidence for the efficacy of auto-SCT in elderly MM patients. A prospective study of auto-SCT in elderly patients using strict eligibility criteria is required to evaluate the prolongation of survival in the era of novel agents.
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U2 - 10.2169/internalmedicine.52.8390
DO - 10.2169/internalmedicine.52.8390
M3 - Article
C2 - 23291675
AN - SCOPUS:84871981152
SN - 0918-2918
VL - 52
SP - 63
EP - 70
JO - Internal Medicine
JF - Internal Medicine
IS - 1
ER -