Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center Petah, Tikvah, Israel.
Bone Marrow Transplant. 2021 May;56(5):1144-1150. doi: 10.1038/s41409-020-01159-9. Epub 2020 Dec 4.
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/m. 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.
自体干细胞移植（ASCT）已经被用于治疗多发性骨髓瘤（MM）超过三十年，通常保留给年龄小于 65 岁的患者。在此，我们报告了 Mayo 诊所一组年龄≥75 岁的 MM 患者门诊 ASCT 的结果。2005 年 10 月至 2020 年 8 月，50 名年龄≥75 岁的患者在 Mayo 诊所接受了 ASCT。从诊断到 ASCT 的中位时间为 6.85 个月（IQR 5.2-10.52），50%接受了强度降低的马法兰 140mg/m2 预处理。48%的患者无需住院即可完成 ASCT，52%（n=26）的患者需要住院，中位住院时间为 9 天（IQR 5-13）。住院的原因包括发热或感染（32%）、心律失常（36%）和脱水（32%）。总缓解率为 100%，其中 57%的患者达到完全缓解。该队列的中位总生存期和无进展生存期分别为 82 个月和 33 个月。1 例患者在移植后 100 天内死亡，100 天死亡率为 2%。ASCT 是安全有效的，在精心挑选的年龄在 75 岁或以上的 MM 患者中，我们认为年龄不应该是 MM 患者接受 ASCT 的排除因素。
