PB2456: SURVIVAL OF MULTIPLE MYELOMA PATIENTS YOUNGER AND OLDER THAN 60 YEARS AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION

Abstract Topic: 22. Stem cell transplantation - Clinical

Background: A cautious attitude towards patients with multiple myeloma (MM) over 60 years of age as potential candidates for autologous hematopoietic stem cell transplantation (AutoHSCT) is often due to low somatic status and/or the presence of comorbidities that increase the likelihood of developing severe complications after high-dose chemotherapy. Improving the somatic condition, resolving comorbidities, and improving the quality of life in the case of effective therapy expands the possibilities for performing AutoHSCT in older people.

Aims: Comparative analysis of survival of patients with MM in groups ≤ 60 years and ≥ 61 years.

Methods: A retrospective analysis of the results of AutoHSCT was carried out in 107 patients, of which 78 were ≤60 years of age and younger and 29 patients were 61 years of age and older.

Results: There were no differences between the groups in terms of drugs used in the induction period, response variant and MRD negative status before AutoHSCT. In the first group, cyclophosphamide at a dose of 3 g/m/2 was significantly more frequently used as a mobilization regimen: 29.5% vs 6.9% in the second group; p=0.014. The Mel200 conditioning regimen was significantly more frequently prescribed in the first group (66.7% vs 44.8%; p=0.039), while the Mel140 regimen was used more frequently in the second group (31.1% vs 10.3%; p=0.009). The number of patients receiving G-CSF in the post-transplant period was the same: 85.9% and 93.1%, respectively. There were no differences in the number of febrile patients (70.5% vs 65.5%, respectively). The number of patients requiring transfusions of donor erythrocytes (33.3% and 31.0%, respectively) and platelet concentrate (98.7% and 96.6%, respectively) did not differ. The difference in the number of transfused doses in the groups was not significant: donor erythrocytes 1 dose vs 2 doses, respectively, and platelet concentrate 2 doses vs 3 doses, respectively. The median PFS in group 1 was 30 months vs 47 months in group 2; p=0.704. The median overall survival in the groups was 57 months vs not achieved, respectively; p=0.577.

Summary/Conclusion: The comparable survival rate of MM patients under the age of 70 years justifies the expediency of increasing the number of patients of the older age group who can undergo AutoHSCT by improving the general somatic status and improving the functional state of vital organs against the background of adequately chosen therapy and choosing appropriate modes of mobilization and conditioning.

Keywords: Multiple myeloma, Autologous peripheral blood stem cell tansplantati