TY - JOUR
T1 - Age Is a Prognostic Factor for the Overall Survival of Patients with Multiple Myeloma Undergoing Upfront Autologous Hematopoietic Stem Cell Transplantation
AU - Cordas dos Santos, David M.
AU - Saliba, Rima M.
AU - Patel, Romil
AU - Bashir, Qaiser
AU - Saini, Neeraj
AU - Hosing, Chitra
AU - Kebriaei, Partow
AU - Khouri, Issa F.
AU - Nieto, Yago
AU - Popat, Uday
AU - Ahmed, Haris
AU - Lee, Hans C.
AU - Manasanch, Elisabet E.
AU - Patel, Krina K.
AU - Thomas, Sheeba K.
AU - Weber, Donna M.
AU - Orlowski, Robert Z.
AU - Champlin, Richard E.
AU - Qazilbash, Muzaffar H.
N1 - Funding Information:
Financial disclosure: The authors have nothing to disclose. Conflict of interest statement: Qaiser Bashir: research funding from Celgene; advisory board member at Spctru, Amgen, Kite Pharma, Takeda. Yago Nieto: research funding from Novartis, Celgene, AstraZeneca; advisory board member at Affirmed. Hans C. Lee: research funding and honoraria from Takeda, Amgen, Janssen. Elisabet E. Manasanch: honoraria from Takeda, Celgene; honoraria and research funding from Sanofi; research funding from Affirmed, Quest Diagnostics, Merck. Authorship statement: D.M.C.D.S. performed research, analyzed/interpreted data, and wrote the paper. R.M.S. R.P. and N.S. analyzed and interpreted data. Q.B. C.H. P.K. I.F.K. Y.N. U.P. H.A. H.C.L. E.E.M. K.K.P. S.K.T. D.M.W. R.J.O. and R.E.C. critically reviewed and revised the manuscript. M.H.Q. designed the study, analyzed data, and wrote the paper. Financial disclosure: See Acknowledgments on page 1082.
Publisher Copyright:
© 2019 American Society for Transplantation and Cellular Therapy
PY - 2020/6
Y1 - 2020/6
N2 - In this retrospective analysis, we evaluated the impact of age on the outcome of patients with multiple myeloma who received an autologous hematopoietic stem cell transplantation (auto-HCT) at our institution. A total of 1128 patients were divided into the older (>70 years; 182 [16%]) and the younger (≤70 years; 946 [84%]) groups. Compared with the younger cohort, older patients had a higher International Staging System (ISS) stage (ISS-II, 57 [31%] versus 215 [23%]; ISS-III, 52 [28%] versus 211 [22%]; P = .01), higher use of reduced-dose melphalan as a conditioning regimen (140 mg/m², 59 [32%] versus 29 [3%]; P < .001), and a higher comorbidity index (median, 3 versus 2; P = .01). Nonrelapse mortality at 1 year after auto-HCT was significantly higher in older patients (7 [4%] versus 9 [1%]; hazard ratio [HR], 4.1; P = .005). Complete remission rates after auto-HCT for the older and the younger groups were 41% and 46%, respectively. With a median follow-up of 52 months, the 5-year progression-free survival (PFS) was 24% (95% confidence interval [CI], 17% to 32%) and 37% (95% CI, 33% to 40%) in the older and younger groups, respectively (HR, 1.3; P = .02). Five-year OS for the older and younger groups was 56% (95% CI, 47% to 64%) and 73% (95% CI, 70% to 76%; P < .001), respectively. Older age emerged as one of the predictors of shorter OS but not PFS in the multivariate classification and regression tree analysis. In conclusion, age ≥70 years was associated with shorter PFS and OS in patients with multiple myeloma who underwent an auto-HCT.
AB - In this retrospective analysis, we evaluated the impact of age on the outcome of patients with multiple myeloma who received an autologous hematopoietic stem cell transplantation (auto-HCT) at our institution. A total of 1128 patients were divided into the older (>70 years; 182 [16%]) and the younger (≤70 years; 946 [84%]) groups. Compared with the younger cohort, older patients had a higher International Staging System (ISS) stage (ISS-II, 57 [31%] versus 215 [23%]; ISS-III, 52 [28%] versus 211 [22%]; P = .01), higher use of reduced-dose melphalan as a conditioning regimen (140 mg/m², 59 [32%] versus 29 [3%]; P < .001), and a higher comorbidity index (median, 3 versus 2; P = .01). Nonrelapse mortality at 1 year after auto-HCT was significantly higher in older patients (7 [4%] versus 9 [1%]; hazard ratio [HR], 4.1; P = .005). Complete remission rates after auto-HCT for the older and the younger groups were 41% and 46%, respectively. With a median follow-up of 52 months, the 5-year progression-free survival (PFS) was 24% (95% confidence interval [CI], 17% to 32%) and 37% (95% CI, 33% to 40%) in the older and younger groups, respectively (HR, 1.3; P = .02). Five-year OS for the older and younger groups was 56% (95% CI, 47% to 64%) and 73% (95% CI, 70% to 76%; P < .001), respectively. Older age emerged as one of the predictors of shorter OS but not PFS in the multivariate classification and regression tree analysis. In conclusion, age ≥70 years was associated with shorter PFS and OS in patients with multiple myeloma who underwent an auto-HCT.
KW - Age
KW - Autologous hematopoietic stem cell transplantation
KW - Multiple myeloma
KW - Retrospective analysis
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U2 - 10.1016/j.bbmt.2019.11.028
DO - 10.1016/j.bbmt.2019.11.028
M3 - Article
C2 - 31786242
AN - SCOPUS:85077150066
SN - 1083-8791
VL - 26
SP - 1077
EP - 1083
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 6
ER -