![]() On the one hand, the lengthening of life expectancy is related to an increase in the incidence of oncological diseases, and on the other hand, the improvement of diagnostic acuity and new therapeutic options on MM has led to a longer survival of elderly patients from median 19 months (in 1973) to 6.1 years (in 2004). Multiple myeloma (MM) is mainly a disease of the elderly. A higher dose of melphalan has more toxicity, but it is globally a well-tolerated procedure. Selected elderly patients when transplanted have similar disease response and survival as younger patients. Survival of transplanted elderly patients was superior to non-transplanted (OS, 59 months vs 30 months, p = 0.037 EFS, 45 months vs 27 months, p = 0.014). ![]() Non-transplanted elderly patients had comparable disease features, and induction response was similar in both groups (before ASCT in the transplanted cohort). Global transplant-related mortality was 3.8%. Those patients also had higher needs of transfusional support, higher grade of mucositis ( p = 0.028), and more days of intravenous antibiotics ( p = 0.019) than the elderly transplanted with MEL140. Stratifying by age, there were no statistically significant differences concerning transplant-related myelotoxicity and non-hematopoietic toxicity however, elderly patients conditioned with MEL200 had higher needs of transfusional support and more days of intravenous antibiotics. Conditioning consisted of melphalan 200 mg/m 2 (MEL200) in younger patients and melphalan 140 mg/m 2 (MEL140) in half of elderly patients. We analyzed a total of 155 patients, 132 of which underwent ASCT (≤ 65 years, n = 103, median 56 years > 65 years, n = 29, median 67 years) and 23 non-transplanted (median 68 years). ![]() A non-transplanted group with similar clinical characteristics, aged 65–70 years old, diagnosed and treated in the same timeline was used for comparison. We performed a retrospective analysis of newly diagnosed MM patients who underwent ASCT between January 2010 and July 2016. Autologous stem cell transplantation (ASCT) is still debatable in treatment of patients over 65 years with multiple myeloma (MM). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |