Trends in autologous hematopoietic cell transplantation for multiple myeloma in Europe: increased use and improved outcomes in elderly patients in recent years.
Autologous hematopoietic cell transplantation (AHCT) is a standard of care in multiple myeloma (MM) patients aged <65 years. To understand age-related trends in utilisation and outcome of AHCT, we analysed 53 675 MM patients who underwent a first AHCT in 31 European countries between 1991 and 2010. The number of patients undergoing AHCT increased for all age groups (<40, 40-49, 50-59, 60-64, 65-69 and ⩾70 years) throughout the observation period. The highest increase was observed for patients aged ⩾65 years, who accounted for 3% of AHCTs in 1991-1995 and for 18.8% of AHCTs in 2006-2010. Risk factors associated with survival over the entire observation period (P<0.001) were calendar period, remission status at AHCT, gender, disease duration before AHCT and age. Survival improved considerably more in older than in younger patients in recent years. In 2006-2010, median 2- and 5-year post-transplant survival ranged from 85.9 and 61.5% in patients <40 years to 80.2 and 49.7% in those ⩾70 years. All-cause day-100 mortality decreased throughout the observation period to ⩽2.4% for all age groups in 2006-2010. The results of this study demonstrate increased utilisation and safety of AHCT with improved post-transplant survival particularly in elderly MM patients in recent years in Europe.
Department of Medicine, Imperial College London, London, UK.
H W
HW
Auner
Department of Medicine, Imperial College London, London, UK.
R
R
Szydlo
Leiden University Medical Centre, Leiden, The Netherlands.
J
J
Hoek
Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
H
H
Goldschmidt
Institut Paoli Calmette, Marseille, France.
A M
AM
Stoppa
The Royal Marsden Hospital, London, UK.
G J
GJ
Morgan
Centre Hospitalier Universitaire, Nantes, France.
P
P
Moreau
Centre Hospitalier Universitaire, Toulouse, France.
M
M
Attal
Centre Hospitalier Universitaire, Bordeaux, France.
G
G
Marit
Nottingham City Hospital, Nottingham, UK.
N
N
Russell
Sahlgrenska University Hospital, Göteborg, Sweden.
M
M
Brune
St James's Institute of Oncology, Leeds, UK.
G
G
Cook
Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
P
P
Sonneveld
Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
S
S
Schönland
Department of Haematology, Hopital Saint-Antoine, Paris, France.
L
L
Garderet
Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
N
N
Kröger
D000328:Adult; D000367:Age Factors; D000368:Aged; D064592:Autografts; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy*; D012042:Registries; D015996:Survival Rate