Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany; MVZ West GmbH Wuerselen, Hematology - Oncology, Wuerselen, Germany.
Curr Res Transl Med. 2020 Aug;68(3):139-144. doi: 10.1016/j.retram.2020.04.001. Epub 2020 May 4.
In 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.
We 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.
There 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).
our findings support the concept that HDT + ASCT can be safely administered as first-line option for well-selected patients≥65 years.
过去几年，大剂量化疗（HDT）联合自体干细胞移植（ASCT）已广泛应用于老年多发性骨髓瘤（MM）患者。多项研究发现，与年轻患者相比，其生存获益相似。本回顾性研究的目的是分析 HDT+ASCT 在老年患者中的耐受性。
我们通过评估治疗耐受性、住院时间和输血次数，比较了 26 例≥65 岁 MM 患者的 ASCT 和 127 例<65 岁患者的 ASCT。
两组患者的住院时间（老年组 16 天（范围 14-47） vs. 年轻组 17 天（范围 14-71），P=0.0903）、中性粒细胞<500/μl 的中位时间（5 天（范围 4-24） vs. 6 天（范围 3-28），P=0.1091；血小板<30000/μl：6 天（范围 3-36） vs. 7 天（范围 0-53），P=0.274）或并发症的发生率和严重程度均无显著差异。两组即刻和 100 天治疗相关死亡率（TRM）相当（3.85% vs. 1.58%，P=0.4304）。
我们的研究结果支持 HDT+ASCT 可作为一种安全的一线治疗选择，用于精心挑选的≥65 岁患者。
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