Real-life experience with autologous stem cell transplantation in patients with multiple myeloma.

This study reported the use of autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM). The data showed improved outcomes in patients that received ASCT compared to those who did not.

MM is a cancer of plasma cells (myeloma cells). One therapeutic option is high-dose melphalan (Alkeran; HDM) conditioned autologous stem cell transplantation. This treatment uses HDM to kill MM cells. However, this powerful treatment also destroys healthy bone marrow. The ASCT uses healthy stem cells from the patient removed before HDM to replace bone marrow cells and make new healthy ones.

First-line ASCT is recommended by current guidelines for patients with MM as previous studies have shown improved outcomes. Despite this, ASCT utilization has been lower than expected. Therefore, there is a need to examine the use and impact of ASCT in a real-life setting for patients with MM.

This study included 982 patients diagnosed with MM. 746 (76%) patients received ASCT therapy with HDM conditioning, while 236 were given non ASCT therapy.

Patients not undergoing ASCT were older, had more medical conditions associated, and had more disability compared to those that received ASCT. They also had higher-risk MM. Overall, 82.5% of patients under the age of 65 received ASCT compared to 61.1% in those aged 65-70 years.

Patients given ASCT therapy had an average survival without cancer worsening of 45.3 months compared to 35.2 months for those that received non-ASCT therapy. The average overall survival was also significantly higher of those who received ASCT (longer than 76.9 months compared to 64 months). This benefit in survival was similar for all patients who received ASCT, regardless of age.

This study concluded that ASCT provided survival benefits to patients of all ages with MM in a real-world setting.

This study was done in Australia. Therefore, the results may not apply globally.