No Increased Morbidity, Mortality in Older Patients with MM Undergoing Auto-HSCT

Patients aged 75-80 did not have significantly increased morbidity or mortality compared with patients 55-65 when undergoing autologous hematopoietic stem cell transplant (HSCT), according to a retrospective study presented at the 2021 American Society of Hematology Annual Meeting.

 

Nearly half of new diagnosed of multiple myeloma (MM) and non-Hodgkin lymphoma (NHL) are in patients over 75 years old. Such patients, due to their advanced age, have been excluded from key clinical trials examining safety and efficacy of auto HSCT.

 

Researchers from Montefiore Medical Center, which serves a minority population, compared short-term outcomes for auto-HSCT in patients aged 75 or older to those of patients aged 55-65 who were diagnosed with MM or NHL. Patients were conditioned with either melphalan or BEAM.

 

The study included 43 patients aged 75 or older and these patients were matched to 43 patients in the younger group by sex and time of transplant.

 

Admission mortality was not significantly different between the two age groups. There was only one death in the control group. The length of stay was also comparable at 18 days for patients 75 and older and 19 days for patients aged 55-65.

 

Time to white blood cell engraftment in the older patients was 12 days compared with 11 days in the younger group (P=0.032). Time to platelet engraftment was 14 days in the older group compared with 12 days in the younger group (P=0.014). Although these were both significantly longer in the older group, the researchers said the clinical significance of this finding is questionable, as this difference did not seem to prolong length of stay. There were no increased rates of neutropenia, 30-day readmission rate, or ICU admissions in the older group.

 

One and five-year survival rates were also similar between the two groups.

 

Based on these data, auto-HSCT for MM and NHL in patients over 75 years old does not carry increased morbidity or mortality, the researchers concluded.