Clinical lymphoma, myeloma & leukemia · 2026
Real-World Outcomes of High Dose Melphalan and Autologous Stem Cell Transplantation in Patients With Multiple Myeloma Older and Younger Than 65 Years.
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Klomberg KM, Gelderloos M, Kooistra HAM, Nijland M, de Bock GH, Huls GA, Brink M, Roeloffzen WWH, Plattel WJ
Аннотация
BACKGROUND: High dose chemotherapy followed by autologous stem cell transplantation (HDT/ASCT) remains the preferred consolidation strategy for patients with newly diagnosed multiple myeloma (MM). While its use has expanded to patients over 65 years (> 65), few studies have compared real-world outcomes to younger patients.
PATIENTS AND METHODS: This retrospective cohort study included patients with MM who received first line HDT/ASCT between 2013 and 2022 at a large tertiary referral center in The Netherlands. We compared outcomes between patients > 65 years and 65 years or younger (≤ 65), assessing overall survival (OS), time to next treatment or MM-related death (TTNT-D), complications, and quality of life.
RESULTS: Among 394 patients, 109 were > 65 years (range 66-72, 11 patients > 70) and 285 ≤ 65 years (range 34-65). Distributions in baseline characteristics were comparable. Median OS and TTNT-D were 101 and 41 months, respectively, in patients > 65 years compared to 116 (P = .56) and 38 (P = .78) months for patients ≤ 65 years. Age was not a significant predictor. HDT/ASCT was feasible, illustrated by a low serious complications incidence rate and a transplantation-related mortality of 1%. Quality of life data show a stable to increasing trend in the long term.
CONCLUSION: Survival, treatment response, complication rates, and long-term quality of life were comparable between age groups. Our real-world data confirm the safety and efficacy of HDT/ASCT in fit patients with MM over 65 years. These findings support the broader application of HDT/ASCT in selected older patients and reinforce its role.
PATIENTS AND METHODS: This retrospective cohort study included patients with MM who received first line HDT/ASCT between 2013 and 2022 at a large tertiary referral center in The Netherlands. We compared outcomes between patients > 65 years and 65 years or younger (≤ 65), assessing overall survival (OS), time to next treatment or MM-related death (TTNT-D), complications, and quality of life.
RESULTS: Among 394 patients, 109 were > 65 years (range 66-72, 11 patients > 70) and 285 ≤ 65 years (range 34-65). Distributions in baseline characteristics were comparable. Median OS and TTNT-D were 101 and 41 months, respectively, in patients > 65 years compared to 116 (P = .56) and 38 (P = .78) months for patients ≤ 65 years. Age was not a significant predictor. HDT/ASCT was feasible, illustrated by a low serious complications incidence rate and a transplantation-related mortality of 1%. Quality of life data show a stable to increasing trend in the long term.
CONCLUSION: Survival, treatment response, complication rates, and long-term quality of life were comparable between age groups. Our real-world data confirm the safety and efficacy of HDT/ASCT in fit patients with MM over 65 years. These findings support the broader application of HDT/ASCT in selected older patients and reinforce its role.