Tandem autologous stem cell transplantation in elderly patients with myeloma: A multicenter retrospective analysis

Kazuhito Suzuki^{1

2}, Shohei Mizuno³, Yutaka Shimazu⁴, Shin-Ichi Fuchida⁵, Shotaro Hagiwara⁶, Mitsuhiro Itagaki⁷, Kaichi Nishiwaki^{1

2}, Akira Hangaishi⁸, Takahiro Karasuno⁹, Taku Kikuchi¹⁰, Misayo Shimizu¹¹, Akinori Nishikawa¹², Takeshi Kobayashi¹³, Kazutaka Sunami¹⁴, Nobuhiro Hiramoto¹⁵, Hitoji Uchiyama¹⁶, Yumiko Maruyama¹⁷, Yoshinobu Kanda¹⁸, Tatsuo Ichinohe¹⁹, Yoshiko Atsuta^{20

21}, Shingo Yano², Koji Kawamura²²; Working Group of the Japan Society; for Transplantation and Cellular Therapy

Affiliations

¹ Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa, Japan.
² Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa, Japan.
³ Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan.
⁴ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁵ Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan.
⁶ Division of Hematology, Tsukuba University Hospital Mito Clinical Education and Training Center, Tsukuba, Japan.
⁷ Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan.
⁸ Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan.
⁹ Division of Hematology, Rinku General Medical Center, Izumisano, Japan.
¹⁰ Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
¹¹ Department of Hematology and Oncology, Hitachi, Ltd. Hitachi General Hospital, Hitachi, Japan.
¹² Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan.
¹³ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
¹⁴ Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
¹⁵ Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.
¹⁶ Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
¹⁷ Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan.
¹⁸ Division of Hematology, Jichi Medical University, Shimotsuke, Japan.
¹⁹ Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
²⁰ Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan.
²¹ Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan.
²² Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.

PMID: 36597575
DOI: 10.1111/ejh.13922

Multicenter Study

Tandem autologous stem cell transplantation in elderly patients with myeloma: A multicenter retrospective analysis

Kazuhito Suzuki et al. Eur J Haematol. 2023 Apr.

. 2023 Apr;110(4):444-454.

doi: 10.1111/ejh.13922. Epub 2023 Jan 17.

Authors

Affiliations

¹ Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Kashiwa, Japan.
² Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa, Japan.
³ Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan.
⁴ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁵ Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan.
⁶ Division of Hematology, Tsukuba University Hospital Mito Clinical Education and Training Center, Tsukuba, Japan.
⁷ Department of Hematology, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan.
⁸ Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan.
⁹ Division of Hematology, Rinku General Medical Center, Izumisano, Japan.
¹⁰ Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
¹¹ Department of Hematology and Oncology, Hitachi, Ltd. Hitachi General Hospital, Hitachi, Japan.
¹² Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan.
¹³ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
¹⁴ Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
¹⁵ Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.
¹⁶ Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
¹⁷ Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan.
¹⁸ Division of Hematology, Jichi Medical University, Shimotsuke, Japan.
¹⁹ Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
²⁰ Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan.
²¹ Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan.
²² Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.

PMID: 36597575
DOI: 10.1111/ejh.13922

Abstract

Tandem autologous stem cell transplantation (ASCT) has been reconsidered for high-risk patients with myeloma, and the eligibility criteria for up-front ASCT have been updated to include more elderly patients. This study aimed to evaluate the efficacy and tolerability of tandem ASCT in elderly patients with myeloma compared to tandem ASCT in young patients and single ASCT in elderly patients. A retrospective study using the Transplant Registry Unified Management Program database of the Japanese Society for Transplantation and Cellular Therapy, which included 64 elderly and 613 young patients who received tandem ASCT, and 891 elderly patients who received single ASCT, was conducted. The median overall survival (OS) over 38.5 months in the elderly and young patients who received tandem ASCT, and elderly patients who received single ASCT was 78.9, 92.5, and 77.1 months, respectively; no significant difference in the median OS was observed. The cumulative incidence of transplantation-related mortality was similar in the elderly and young patients receiving tandem ASCT. High-risk cytogenetic abnormality was not identified as a poor prognostic factor for OS in elderly patients who received tandem ASCT but in those who received single ASCT. Thus, tandem ASCT was effective and tolerable in elderly patients with myeloma.

Keywords: elderly; high-risk cytogenetic abnormality; multiple myeloma; safety; tandem autologous stem cell transplantation.

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References

REFERENCES

1. Kumar SK, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111:2516-2520.
1. Palumbo A, Cavallo F, Gay F, et al. Autologous transplantation and maintenance therapy in multiple myeloma. N Engl J Med. 2014;371:895-905.
1. Gay F, Oliva S, Petrucci MT, et al. Chemotherapy plus lenalidomide versus autologous transplantation, followed by lenalidomide plus prednisone versus lenalidomide maintenance, in patients with multiple myeloma: a randomised, multicentre, phase 3 trial. Lancet Oncol. 2015;16:1617-1629.
1. Cavo M, Gay F, Beksac M, et al. Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/HO95): a multicentre, randomised, open-label, phase 3 study. Lancet Haematol. 2020;7:e456-e468.
1. Attal M, Lauwers-Cances V, Hulin C, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. N Engl J Med. 2017;376:1311-1320.

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Tandem autologous stem cell transplantation in elderly patients with myeloma: A multicenter retrospective analysis

Affiliations

Tandem autologous stem cell transplantation in elderly patients with myeloma: A multicenter retrospective analysis

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical