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Autologous stem cell transplantation for multiple myeloma patients aged ≥ 75 treated with novel agents

Bone Marrow Transplantation volume 56, pages 1144–1150 (2021)Cite this article

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Abstract

Autologous stem cell transplantation (ASCT) has been used for treating multiple myeloma (MM) for over three decades and is generally reserved for patients younger than 65. Herein we report on outcomes of outpatient ASCT in a cohort of patients with MM aged ≥75 years. Between October 2005 and August 2020, 50 patients aged ≥75 years, received an ASCT at Mayo Clinic, Rochester. Median time from diagnosis to ASCT was 6.85 months (IQR 5.2–10.52) and 50%. received reduced intensity conditioning with melphalan 140 mg/m2. 48% of patients completed the ASCT without requiring hospitalization and 52% (n = 26) of patients required hospitalization with a median duration of hospital admission of 9 days (IQR 5–13). Reasons for hospitalization included fever or infection (32%), cardiac arrhythmia (36%), and dehydration (32%). Overall response rate was 100% with a complete response seen in 57% of patients. Median overall survival and progression free survival for the cohort were 82 months and 33 months, respectively. One patient died within 100 days of transplant representing a 2% 100-day mortality rate. ASCT is safe and efficacious in carefully selected MM patients aged 75 or above and we believe that age should not be an exclusion factor for ASCT in MM.

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Funding

Grant Funding Amyloidosis Foundation; International Waldenstom Foundation. NCI SPORE MM SPORE 5P50 CA186781-04.

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Authors and Affiliations

  1. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    Iuliana Vaxman, Alissa Visram, Shaji Kumar, Angela Dispenzieri, Francis Buadi, David Dingli, Martha Lacy, Eli Muchtar, Prashant Kapoor, William Hogan, Suzanne Hayman, Nelson Leung, Wilson Gonsalves, Taxiarchis Kourelis, Rahma Warsame & Morie A. Gertz

  2. Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah, Tikvah, Israel

    Iuliana Vaxman & Tamar Berger

  3. Sackler Faculty of Medicine Tel-Aviv University, Tel-Aviv, Israel

    Iuliana Vaxman & Tamar Berger

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Correspondence to Morie A. Gertz.

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MG reports personal fees from Ionis/Akcea, personal fees from Alnylam, personal fees from Prothena,, personal fees from Janssen, grants and personal fees from Spectrum, personal fees from Annexon, personal fees from Appellis, personal fees from Amgen, personal fees from Medscape, personal fees from Physicians Education Resource, personal fees for Data Safety Monitoring board from Abbvie and Celgene, personal fees from Research to Practice, workforce training Sanofi, speaker fees from Teva, Speaker fees from Johnson and Johnson; Speaker fees from Medscape, Speaker fees DAVA oncology; Advisory Board for Pharmacyclics Advisory Board for Proclara; Development of educational materials for i3Health. Educational Program development i3Health. Royalties from Springer Publishing, Stock Options Aurora Bio

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Vaxman, I., Visram, A., Kumar, S. et al. Autologous stem cell transplantation for multiple myeloma patients aged ≥ 75 treated with novel agents. Bone Marrow Transplant 56, 1144–1150 (2021). https://doi.org/10.1038/s41409-020-01159-9

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