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Impact of novel agents followed by autologous hematopoietic stem cell transplantation for multiple myeloma patients aged 65 years or older: a retrospective single Institutional analysis

Bone Marrow Transplantation volume 50, page 1486 (2015)Cite this article

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Multiple myeloma (MM) is a disease of the elderly, with two-thirds of the affected population aged over 65 years. The introduction of novel agents in front-line treatment has improved the outcome of young as well as elderly patients. It is also contributing to an ever-increasing utilization of autologous stem cell transplantation (ASCT), by making a greater number of patients ⩾65 years eligible for this procedure.1, 2, 3 Recent reports have documented a better event-free survival with the use of maintenance therapy (with interferon-alfa, bortezomib and immunomodulatory drugs) after ASCT in elderly patients.4 Data on the benefits of bortezomib and immunomodulatory drugs in the induction phase followed by ASCT in the elderly population are also emerging.5

We retrospectively evaluated clinical data on MM patients who underwent ASCT at our Institution. From January 1997 to January 2015, 56 consecutive MM patients aged over 65 years received ASCT. From 1997 to 2002, 22 patients (12 male (M), 10 female (F); median age 68 years, range 65–73) had received a conditioning regimen with oral busulphan plus IV melphalan; this group was considered only for the survival analysis as a historical control. From 2003, 34 patients (20 M, 14 F; median age 67, range 65–72) had received a conditioning regimen with high (200 mg/m2, n=12) or intermediate (140 or 100 mg/m2, n=22) doses of IV melphalan; induction therapy included novel agents (thalidomide and/or bortezomib) for 23 patients (67%); disease status at ASCT was CR/very good partial response (n=16), PR (n=16) and no response (n=2);6 the median number of reinfused CD34+ hematopoietic stem cells was 5.8 × 106/Kg (range 2.3–11.5); 12 patients received consolidation therapy with bortezomib and/or thalidomide and 5 maintenance with interferon-α. Stem cell mobilization was carried out with high-dose cyclophosphamide (3–5 g/m2) and granulocyte-colony stimulating factor (G-CSF) or pegfilgrastim administration.

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References

  1. Auner HW, Szydlo R, Hoek J, Goldschmidt H, Stoppa AM, Morgan GJ et al. Trends in autologous hematopoietic cell transplantation for multiple myeloma in Europe: increased use and improved outcomes in elderly patients in recent years. Bone Marrow Transplant 2015; 50: 209–215.

    Article  CAS  Google Scholar 

  2. Palumbo A, Mina R . Management of older adults with multiple myeloma. Blood Rev 2013; 27: 133–142.

    Article  CAS  Google Scholar 

  3. Zweegman S, Palumbo A, Bringhen S, Sonneveld P . Age and aging in blood disorders: multiple myeloma. Haematologica 2014; 99: 1133–1137.

    Article  Google Scholar 

  4. Merz M, Neben K, Raab MS, Sauer S, Egerer G, Hundemer M et al. Autologous stem cell transplantation for elderly patients with newly diagnosed multiple myeloma in the era of novel agents. Ann Oncol 2014; 25: 189–195.

    Article  CAS  Google Scholar 

  5. Ozaki S, Harada T, Saitoh T, Shimazaki C, Itagaki M, Asaoku H et alJapanese Society of Myeloma; European Myeloma Network. Survival of multiple myeloma patients aged 65–70 years in the era of novel agents and autologous stem cell transplantation. A multicenter retrospective collaborative study of the Japanese Society of Myeloma and the European Myeloma Network. Acta Haematol 2014; 132: 211–219.

    Article  Google Scholar 

  6. Engelhardt M, Terpos E, Kleber M, Gay F, Wäsch R, Morgan G et al. European Myeloma Network. European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma. Haematologica 2014; 99: 232–242.

    Article  CAS  Google Scholar 

  7. Palumbo A, Bringhen S, Mateos MV, Larocca A, Facon T, Kumar SK et al. Geriatric assessment predicts survival and toxicities in elderly myeloma patients: an International Myeloma Working Group report. Blood 2015; 125: 2068–2074.

    Article  CAS  Google Scholar 

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Acknowledgements

We would like to thank Caroline Oakley for linguistic revision of the manuscript.

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Authors and Affiliations

  1. Haematology Unit and BMT, 'San Giuseppe Moscati' Hospital, Taranto, Italy

    C Minoia, G Pisapia, G Palazzo, C Ingrosso, M Buonanno, C Spinosa, A Prudenzano, G Pricolo & P Mazza

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  1. C Minoia
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  2. G Pisapia
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  3. G Palazzo
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  4. C Ingrosso
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  7. A Prudenzano
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  8. G Pricolo
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Correspondence to C Minoia.

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Minoia, C., Pisapia, G., Palazzo, G. et al. Impact of novel agents followed by autologous hematopoietic stem cell transplantation for multiple myeloma patients aged 65 years or older: a retrospective single Institutional analysis. Bone Marrow Transplant 50, 1486 (2015). https://doi.org/10.1038/bmt.2015.185

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