1. ¹Department of Medicine, Kuopio University Hospital, Kuopio, Finland
2. ²Department of Clinical Chemistry, Kuopio University Hospital, Kuopio, Finland

Correspondence: Dr E Jantunen, Department of Medicine, Kuopio University Hospital, PO Box 1777, 70211 Kuopio, Finland. E-mail: esa.jantunen@kuh.fi

Received 29 November 2005; Revised 3 January 2006; Accepted 9 January 2006.

Abstract

Limited information is available on the feasibility and efficacy of autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients >65 years of age. In 1995–2005, 22 myeloma patients 65 years (median 68, eight 70) and 79 patients <65 years (median 57) were included in an identical treatment protocol. The first progenitor cell mobilization with cyclophosphamide plus granulocyte-colony stimulating factor (G-CSF) was successful in 95 and 96% of the patients, respectively. To date, 92 patients have received MEL (melphalan) 200 mg/m² supported by ASCT. No early treatment-related deaths were observed among 22 elderly patients, whereas one younger patient died early. Engraftment and the need for supportive care were comparable between groups. The elderly patients tended to have more WHO grade 3–4 oral or gastrointestinal toxicity when compared to the younger patients (45 vs 23%, P=0.06). After ASCT, a complete response was observed in 44% of the elderly patients and 36% of the younger patients, respectively. No difference was observed between these age groups in progression-free survival (23 vs 21 months) or overall survival (57 vs 66 months) after ASCT. We conclude that MEL200 is a safe and efficacious treatment in selected elderly myeloma patients.