title: Survival of elderly patients with multiple myeloma-Effect of upfront autologous stem cell transplantation.
abstract: The aim of this study was to determine the value of upfront autologous transplantation (ASCT) in elderly patients (60-79 years) with myeloma.
  
  
  
  We analysed relative survival (RS) of patients diagnosed in 1998-2011 and treated with ASCT within 12 months after diagnosis in Germany (n = 3591; German Registry of Stem Cell Transplantation) and compare RS with survival of myeloma patients diagnosed in the same years in Germany (n = 13,903; population-based German Cancer Registries).
  
  
  
  Utilisation of ASCT has increased rapidly between 2000-2002 and 2009-2011 (60-64years: 7.0-43.0%; 65-69 years: 6.6-23.7%; 70-79 years: 0.4-4.0%). Comparison of 5-year RS of patients from the general German myeloma population who have survived the first year after diagnosis with 5-year RS of patients treated with ASCT revealed higher survival for transplanted patients among all age groups (60-64: 59.2% versus 66.1%; 65-69: 57.4% versus 61.7%; 70-79: 51.0% versus 56.6%). RS increased strongly between 2003-2005 and 2009-2011 for the general German myeloma population (+8.5%) and for patients treated with ASCT (+11.8%). Differences in RS between these groups increased over time from +1.9% higher age-standardised survival in transplanted patients in 2003-2005 to 5.2% higher survival in 2009-2011.
  
  
  
  We conclude that upfront ASCT might be a major contributor to improved survival for elderly myeloma patients in Germany.
authors.affiliation: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: maximilian.merz@med.uni-heidelberg.de.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Merz
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Jansen
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Castro
authors.affiliation: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Hillengass
authors.affiliation: Asklepios Klinik Hamburg Altona, Hamburg, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Salwender
authors.affiliation: Universitätsklinikum Tübingen, Tübingen, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Weisel
authors.affiliation: Universitätsklinikum Köln, Köln, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
authors.affiliation: Cancer Registry of Bremen, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Luttmann
authors.affiliation: Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Emrich
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany.
authors.forename: Alice
authors.initials: A
authors.lastname: Nennecke
authors.affiliation: Schön Klinik Starnberger See, Berg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Straka
authors.affiliation: Universitätsklinikum Ulm, Ulm, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Langer
authors.affiliation: Universitätsklinikum Freiburg, Freiburg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Engelhardt
authors.affiliation: Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.affiliation: Interdisziplinäre Klinik für Stammzelltransplantation, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.affiliation: Klinik für Knochenmarktransplantation des Universitätsklinikum Essen, Essen, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beelen
authors.affiliation: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Dreger
authors.affiliation: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Brenner
authors.affiliation: Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
mesh_terms: D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014182:Transplantation, Autologous
keywords: Autologous stem cell transplantation; Elderly; Multiple myeloma; Population-based survival analysis