Document Detail

Evaluation of the feasibility and efficacy of autologous stem cell transplantation in elderly patients with multiple myeloma.
MedLine Citation:
PMID:  23291675     Owner:  NLM     Status:  In-Data-Review    
Objective The feasibility and efficacy of high-dose melphalan (HD-MEL) followed by autologous hematopoietic stem cell transplantation (auto-SCT) in elderly patients with multiple myeloma (MM) are discussed. Methods We retrospectively analyzed and compared the results of 25 elderly patients (aged 65-76 years, elderly group) and 63 control patients (aged 51-64 years, control group). Many patients received a vincristine and doxorubicin combined with dexamethasone (VAD) regimen (elderly group: 92%, control group: 78%) with autologous peripheral blood stem cells being harvested after the administration of chemotherapy with high-dose cyclophosphamide (elderly group: 72%, control group: 87%). Ten elderly patients received MEL at a dose of 100-120 mg/m(2), while 15 patients received MEL at a dose of 180-200 mg/m(2). Results Treatment-related deaths occurred in one elderly patient and two younger patients due to infections. The rate of achieving complete response (CR) or very good partial response (VGPR) was 60% in the elderly group and 83% in the control group. Progression-free survival from auto-SCT in the elderly group was similar to that observed in the control group (median 17.1 vs. 20.8 months, p=0.26), with the median overall survival (OS) from auto-SCT being 40.8 months in the former and 72.5 months in the latter group (p=0.07). When calculated from the beginning of induction treatment, the median OS of the elderly group was 47.0 months and the 3-year OS rate was 81%. Conclusion The current study provides evidence for the efficacy of auto-SCT in elderly MM patients. A prospective study of auto-SCT in elderly patients using strict eligibility criteria is required to evaluate the prolongation of survival in the era of novel agents.
Tsuyoshi Muta; Toshihiro Miyamoto; Tomoaki Fujisaki; Yuju Ohno; Tomohiko Kamimura; Koji Kato; Katsuto Takenaka; Hiromi Iwasaki; Tetsuya Eto; Yasushi Takamatsu; Takanori Teshima; Koichi Akashi;
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Publication Detail:
Type:  Journal Article     Date:  2013-01-01
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  52     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  63-70     Citation Subset:  IM    
Department of Hematology/Oncology, Kyushu University Hospital, Japan.
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