Autologous stem cell transplantation in elderly patients with multiple myeloma in Korea: the KMM1807 study
Authors
Jongheon Jung ; Yoon Seok Choi ; Jae Hoon Lee ; Won Sik Lee ; Sung-Hyun Kim ; Yong Park ; Seung-Shin Lee ; Young Rok Do ; Jae-Cheol Jo ; Je-Jung Lee ; Jin Seok Kim ; Ho-Jin Shin ; Dong-Yeop Shin ; Sung-Soo Yoon ; Chang-Ki Min ; Kihyun Kim ; Hyeon-Seok Eom ; Korean Multiple Myeloma Working Party
Citation
INTERNATIONAL JOURNAL OF HEMATOLOGY, Vol.112(1) : 84-95, 2020-07
Autologous stem cell transplantation (ASCT) is not frequently performed for elderly patients multiple myeloma (MM) in Korea, despite its being a standardized approach for young patients. Medical records of 150 patients from 15 Korean institutions who received ASCT at age ≥ 64 years were analyzed retrospectively. Patients included had symptomatic MM, and had received their first ASCT at age ≥ 64 following induction chemotherapy. The main outcome was the response after ASCT. Overall survival (OS) and progression-free survival (PFS) were also analyzed. Median time to ASCT was 6.3 months. Complete response plus stringent complete response rate increased from 36 (24.0%) to 105 (70.0%) after ASCT, and high-quality response (≥ very good partial response) increased from 96 (64.0%) to 125 (83.3%). With a median follow-up of 32.6 months after ASCT, 5-year OS and PFS were 59.7% and 22.8%, respectively. Febrile neutropenia occurred in 43.5%, and nausea (21.3%) and stomatitis (13.2%) were common grade 3-4 non-hematologic adverse events. Of 44 deaths, disease progression (n = 23) was the most common cause of mortality, followed by infection (n = 13). Treatment-related death occurred in four cases (2.7%). ASCT is an effective and safe option for elderly MM patients and is associated with superior clinical outcomes.