In a nutshell
This study examined the safety and effectiveness of stem cell transplantation (SCT) in elderly patients with multiple myeloma (MM) aged 65 or older compared to younger patients. The authors concluded that SCT was equally as safe and effective for patients in both age groups.
Multiple myeloma is a complex type of cancer with many types of treatment available. Combining different therapies is a commonly used approach. This can include chemotherapy, new targeted therapies, and SCT. This combined approach has improved outcomes in younger patients with MM.
However, whether SCT is safe and effective for elderly patients with MM remains unclear. Previous studies suggest that some of these patients may be good candidates for autoSCT. Determining which patients are good candidates remains challenging.
Methods & findings
This study had 2056 patients with MM. Patients received SCT, chemotherapy and/or targeted therapy. Patients were divided into two age groups: 1769 patients under age 65 and 287 patients over age 65. 88 elderly patients who only received SCT and chemotherapy were compared to patients who also received targeted therapy (287 patients). All patients were followed-up for an average of 624 – 788 days.
100 days after treatment, the mortality rates between older patients and younger patients were not significantly different (1.2%, patients over 65 vs. 0.4%, patients under 65). Infection was the most common cause of mortality in both groups.
Overall, the likelihood of surviving 5 years later was not significantly different between both groups (63.5%, patients over 65 vs. 62.5%, patients under 65). However, this rate significantly increased for patients over age 65 who had targeted therapy, SCT, and chemotherapy (63.5%) compared to patients who did not receive targeted therapy (42.6%).
The bottom line
This study concluded that autoSCT is safe and effective for elderly patients with MM. The authors suggest that the addition of new targeted therapies can help improve outcomes for these patients.
The fine print
This study was carried out retrospectively using Japanese national registry records. Some data was not available, which limits the conclusions that may be drawn. More studies are needed to understand the patient criteria that give the best chance of success for SCT.
Talk to your doctor about the potential benefits of combining SCT, chemotherapy, and targeted therapy.
Published By :
Bone Marrow Transplantation
Feb 19, 2019
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