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AUTOLOGOUS TRANSPLANTATION FOR MULTIPLE MYELOMA IN GERMANY -REAL-WORLD DATA FROM A NATIONWIDE, MULTI-INSTITUTIONAL SURVEY IN 2015-2016
Author(s): ,
Maximilian Merz
Affiliations:
Klinik für Innere Medizin V,Universitätsklinikum Heidelberg,Heidelberg,Germany
,
Lenka Kellermann
Affiliations:
OncologyInformationService,Freiburg,Germany
,
Wolfram Poenisch
Affiliations:
Universitätsklinikum Leipzig,Leipzig,Germany
,
Ulrich Mahlknecht
Affiliations:
Innere Medizin Hämatologie und Internistische Onkologie,Kplus-Gruppe GmbH - St. Lukas Klinik,Solingen,Germany
,
Stefan Fries
Affiliations:
Onkologische Schwerpunktpraxis,Bamberg,Germany
Hartmut Goldschmidt
Affiliations:
Nationales Centrum für Tumorerkrankungen (NCT),Heidelberg,Germany
(Abstract release date: 05/18/17) EHA Library. Merz M. 05/18/17; 182680; PB1966
Dr. Maximilian Merz
Dr. Maximilian Merz
Contributions
Abstract

Abstract: PB1966

Type: Publication Only

Background
A nationwide, multi-institutional survey was performed in 2015 and 2016 to analyse routine practice for myeloma patients outside clinical trials in Germany.

Aims
We aimed to investigate implementation of autologous stem cell transplantation (ASCT) into treatment of patients with newly diagnosed or relapsed multiple myeloma (MM) in Germany.

Methods

The analysis is based on a database built from university hospitals (UH), community hospitals (CH), office-based hematologists (OBH). Anonymized data were collected online based on retrospective chart review. The completeness and the plausibility of the data were verified in real-time and by online personal checks. We investigated which institutions initiated treatment in patients with ASCT, which were the characteristics for patients not-considered eligible for transplantation, how stem cell mobilization was performed, how many patients dropped out before planned transplantation and what were the frequencies of tandem ASCT and ASCT for relapsed disease.

Results
Data from 515 patients from 51 centres were available for the first half of 2015 and from 867 patients from 52 centres for the first half of 2016. There were 40% (2015) and 32% (2016) pts considered as eligible for ASCT in 1st line. Although the proportion of patients older than 69 years was not significantly different between health care providers in 2015 and 2016 (2015: 47%UH, 60%CH, 49%OBP / 2016: 54%UH, 56% CH, 47%OBP), patients were considered more often transplant-eligible in UH (2015: 49% / 2016: 53%) than in CH (2015: 29% / 2016: 21%) or OBH (2015: 45% / 2016: 26%). In first-line treatment, 52% of patients eligible for SCT received mobilization chemotherapy in addition to induction therapy. More than 80% of patients received a cyclophosphamide-based chemotherapy in combination with G-CSF for stem cell mobilization in 2015 and 2016. Most participating institutions aimed at collection of three sufficient stem cell transplants (2015: 48% / 2016: 46%). Once patients completed stem cell mobilization, 92% continued to high-dose chemotherapy and 92% of them received ASCT finally. 25% of transplant patients were treated with tandem ASCT in 1st line. In 2015, 8% of patients and 1% of patients in 2016 were considered eligible and were ultimately treated with ASCT for relapsed disease. The most frequent reason for transplant-eligible patients not receiving ASCT were withdrawal of patients consent (first-line: 15%, second-line: 39%).

Conclusion
With our current analysis of a nationwide survey performed with different health care providers in Germany we demonstrate that implementation of ASCT is strongly influenced by the institution initiating primary therapy. Age does not seem to impact usage of ASCT compared to concomitant disease or patients´ and doctors´ preferences. Patients predominantly collect three autologous transplants, enabling a possible tandem ASCT and ASCT for relapsed disease.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Myeloma, Clinical data, Autologous bone marrow transplant

Abstract: PB1966

Type: Publication Only

Background
A nationwide, multi-institutional survey was performed in 2015 and 2016 to analyse routine practice for myeloma patients outside clinical trials in Germany.

Aims
We aimed to investigate implementation of autologous stem cell transplantation (ASCT) into treatment of patients with newly diagnosed or relapsed multiple myeloma (MM) in Germany.

Methods

The analysis is based on a database built from university hospitals (UH), community hospitals (CH), office-based hematologists (OBH). Anonymized data were collected online based on retrospective chart review. The completeness and the plausibility of the data were verified in real-time and by online personal checks. We investigated which institutions initiated treatment in patients with ASCT, which were the characteristics for patients not-considered eligible for transplantation, how stem cell mobilization was performed, how many patients dropped out before planned transplantation and what were the frequencies of tandem ASCT and ASCT for relapsed disease.

Results
Data from 515 patients from 51 centres were available for the first half of 2015 and from 867 patients from 52 centres for the first half of 2016. There were 40% (2015) and 32% (2016) pts considered as eligible for ASCT in 1st line. Although the proportion of patients older than 69 years was not significantly different between health care providers in 2015 and 2016 (2015: 47%UH, 60%CH, 49%OBP / 2016: 54%UH, 56% CH, 47%OBP), patients were considered more often transplant-eligible in UH (2015: 49% / 2016: 53%) than in CH (2015: 29% / 2016: 21%) or OBH (2015: 45% / 2016: 26%). In first-line treatment, 52% of patients eligible for SCT received mobilization chemotherapy in addition to induction therapy. More than 80% of patients received a cyclophosphamide-based chemotherapy in combination with G-CSF for stem cell mobilization in 2015 and 2016. Most participating institutions aimed at collection of three sufficient stem cell transplants (2015: 48% / 2016: 46%). Once patients completed stem cell mobilization, 92% continued to high-dose chemotherapy and 92% of them received ASCT finally. 25% of transplant patients were treated with tandem ASCT in 1st line. In 2015, 8% of patients and 1% of patients in 2016 were considered eligible and were ultimately treated with ASCT for relapsed disease. The most frequent reason for transplant-eligible patients not receiving ASCT were withdrawal of patients consent (first-line: 15%, second-line: 39%).

Conclusion
With our current analysis of a nationwide survey performed with different health care providers in Germany we demonstrate that implementation of ASCT is strongly influenced by the institution initiating primary therapy. Age does not seem to impact usage of ASCT compared to concomitant disease or patients´ and doctors´ preferences. Patients predominantly collect three autologous transplants, enabling a possible tandem ASCT and ASCT for relapsed disease.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Myeloma, Clinical data, Autologous bone marrow transplant

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