title: Autologous stem cell transplantation in elderly patients with multiple myeloma: evaluation of its safety and efficacy.
abstract: Administering high-dose chemotherapy (HDCT) with melphalan to elderly myeloma patients represents a challenge with respect to achieving therapeutic efficacy whilst avoiding significant toxicity. We analyzed safety and efficacy of HDCT in 61 elderly myeloma patients older than 65 years, including 12 patients ≥70 years, and compared them with 237 MM patients below 65 years treated in the same period. We observed no differences in the time until neutrophil recovery, infection rate, and treatment related mortality until 100 days after ASCT. Furthermore, higher age was not associated with inferior progression-free and overall survival at 1 and 2 years after ASCT. However, MM patients older than 70 years had a longer duration of hospitalization (26 vs. 20 days; p= .0001) and a longer time until platelet recovery >20G/L (20 vs. 13 days; p= .0007). Our data suggest that HDCT with ASCT is feasible, safe and effective in MM patients older than 65 years.
authors.affiliation: a Department of Medical Oncology, Inselspital , University Hospital Bern , Bern , Switzerland.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Stettler
authors.affiliation: a Department of Medical Oncology, Inselspital , University Hospital Bern , Bern , Switzerland.
authors.forename: Urban
authors.initials: U
authors.lastname: Novak
authors.affiliation: b Department of Hematology, Inselspital , University Hospital Bern , Bern , Switzerland.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Baerlocher
authors.affiliation: c Department of Clinical Research , University of Bern , Bern , Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Seipel
authors.affiliation: b Department of Hematology, Inselspital , University Hospital Bern , Bern , Switzerland.
authors.forename: Behrouz
authors.initials: B
authors.lastname: Mansouri Taleghani
authors.affiliation: a Department of Medical Oncology, Inselspital , University Hospital Bern , Bern , Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pabst
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007132:Immunoglobulin Isotypes
keywords: Myeloma; autologous; efficacy; elderly; high-dose chemotherapy; prognosis; safety; stem cell; survival; transplant