MM-531 Case Control Study of Outcomes of Autologous Stem Cell Transplantation in Jehovah's Witness Multiple Myeloma Patients

Abstract

Jehovah's Witnesses (JW) persons do not accept blood transfusions. Autologous stem cell transplantation (ASCT) after using high-dose chemotherapy is the standard of care in treatment of multiple myeloma (MM). Patients usually require blood transfusions during ASCT. We sought to analyze safety outcomes of single or tandem ASCT in JW MM patients. We performed a case control study at the University of Arkansas for Medical Sciences for JW and non-JW MM patients who underwent single or tandem ASCT from 1990-2021. Matching (1:2) was done based on age, date of MM diagnosis, race/ethnicity, performance status, stage indicated by International Staging System (ISS), and number of ASCT. Wilcoxon Rank-Sum test was used to test continuous variables, while Fisher's exact test was used for categorical variables. A total of 13 JW MM patients received ASCT in the study period (8 single, 5 tandem) compared to 26 non-JW MM patients (16 single, 10 tandem). For JW patients who received single ASCT, median age was 66 (range:65.8-67.5 years), 50% were female, 62.5% were black. Average CD34 stem cells collected/infused were 23/5.8 million cells in JW compared to 30.1/5.1 million cells in non-JW, respectively. For JW patients who received tandem ASCT, median age was 49 (range:46-52 years), 50% were female, 62.5% were black. Average CD34 stem cells collected/infused were 34/10.8 million in JW compared to 21.3/8.8 million in non-JW, respectively. Lowest hemoglobin and platelets level in JW were 6.6 g/dl and 3000 k/uL, respectively. 100-days mortality for all patients was 0%. Multivariable analysis showed no significant difference in 30 days/100 days re-hospitalization, major and/or minor bleeding adverse events, response to treatment (very good partial response or better). Bloodless single/tandem ASCT can be done safely for selected JW MM patients with no significant difference in safety/outcomes.