Autologous stem cell transplantation in elderly patients with multiple myeloma in Korea: the KMM1807 study

Abstract

Autologous stem cell transplantation (ASCT) is not frequently performed for elderly patients multiple myeloma (MM) in Korea, despite its being a standardized approach for young patients. Medical records of 150 patients from 15 Korean institutions who received ASCT at age ≥ 64 years were analyzed retrospectively. Patients included had symptomatic MM, and had received their first ASCT at age ≥ 64 following induction chemotherapy. The main outcome was the response after ASCT. Overall survival (OS) and progression-free survival (PFS) were also analyzed. Median time to ASCT was 6.3 months. Complete response plus stringent complete response rate increased from 36 (24.0%) to 105 (70.0%) after ASCT, and high-quality response (≥ very good partial response) increased from 96 (64.0%) to 125 (83.3%). With a median follow-up of 32.6 months after ASCT, 5-year OS and PFS were 59.7% and 22.8%, respectively. Febrile neutropenia occurred in 43.5%, and nausea (21.3%) and stomatitis (13.2%) were common grade 3–4 non-hematologic adverse events. Of 44 deaths, disease progression (n = 23) was the most common cause of mortality, followed by infection (n = 13). Treatment-related death occurred in four cases (2.7%). ASCT is an effective and safe option for elderly MM patients and is associated with superior clinical outcomes.

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Acknowledgements

This study was performed with the collaboration of 15 institutions belonging to the Korean Multiple Myeloma Working Party (KMMWP).

Funding

This research was supported by National Cancer Center research Grant (1911262-2).

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Correspondence to Kihyun Kim or Hyeon-Seok Eom.

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Jung, J., Choi, Y.S., Lee, J.H. et al. Autologous stem cell transplantation in elderly patients with multiple myeloma in Korea: the KMM1807 study. Int J Hematol 112, 84–95 (2020). https://doi.org/10.1007/s12185-020-02869-y

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Keywords

  • Multiple myeloma
  • Autologous
  • Stem cell
  • Transplantation
  • Elderly