title: Feasibility of autologous hematopoietic stem cell transplant in patients aged ≥70 years with multiple myeloma.
abstract: Abstract   We retrospectively analyzed the outcomes of all consecutive patients with myeloma (n = 84) aged ≥70 years who had received autologous hematopoietic stem cell transplant (auto HCT) between July 1999 and June 2010 at our institution. The median age at auto HCT was 72 years, the median number of prior therapies was 2.5 and the median time from diagnosis to auto HCT was 10.2 months. The conditioning regimen consisted of melphalan at 140 mg/m(2) in 10%, 180 mg/m(2) in 25% and 200 mg/m(2) in 65% of patients. The day-100 non-relapse mortality was 3%. The overall response rate at day 100 was 85% (complete response 18%, very good partial response 12%, partial response 55%). After a median follow-up of 25 months among surviving patients, the estimated progression-free survival and overall survival at 5 years were 27% and 67%, respectively. The incidence of grade II-IV toxicity, response rate and survival were similar across three melphalan dose levels. These results indicate that high-dose melphalan plus auto HCT is safe and feasible for patients with multiple myeloma aged ≥70 years and age alone should not be an exclusion criterion for auto HCT.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA. qbashir@mdanderson.org
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.forename: Simrit
authors.initials: S
authors.lastname: Parmar
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.forename: Donna M
authors.initials: DM
authors.lastname: Weber
authors.forename: Michael
authors.initials: M
authors.lastname: Wang
authors.forename: Robert Z
authors.initials: RZ
authors.lastname: Orlowski
authors.forename: Sheeba K
authors.initials: SK
authors.lastname: Thomas
authors.forename: Jatin
authors.initials: J
authors.lastname: Shah
authors.forename: Sofia R
authors.initials: SR
authors.lastname: Qureshi
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: Dinh
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D009101:Multiple Myeloma / Q000628:therapy*; D015999:Multivariate Analysis; D011379:Prognosis; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan