Tolerability of high dose chemotherapy and autologous stem cell transplantation in elderly patients with multiple myeloma: A single-center retrospective analysis

Abstract

Purpose of the studyIn the past years, high dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT)has more extensively been performed in elderly patients with multiple myeloma (MM). Several studies found a similar survival benefit compared to younger patients. The objective of our retrospective study is to analyse the tolerability of HDT + ASCT in elderly patients. Patients and methodsWe compared 26 ASCT performed in MM patients ≥65 years to 127 ASCT in patients <65 years by evaluating treatment-tolerability, length of hospital stay and number of transfusions. ResultsThere was no significant difference in the duration of hospitalisation (16 days (range 14–47) in the elderly vs. 17 days (range 14–71) days, P = 0.0903), median time of cytopenia (neutrophils<500/μl: 5 days (range 4–24) vs. 6 days (range 3–28) days, P = 0.1091; platelets<30 000/μl: 6 days (range 3–36) vs. 7 days (range 0–53) days, P = 0.274) or incidence of, or degree of complications between the two age-groups. Immediate and day 100 treatment related mortality (TRM) was comparable in both groups (3.85% vs. 1.58%, P = 0.4304). Conclusionour findings support the concept that HDT + ASCT can be safely administered as first-line option for well-selected patients≥65 years.