Contributions
Abstract: PB1983
Type: Publication Only
Background
Aims
Methods
Results
Overall we analized 35 pts: 21 males and 14 females (median age 66, range 65-70); 23 had IgG MM, 4 had IgA MM and 8 had light chain MM. Induction therapy was bortezomib-based (bortezomib in combination with dexamethasone, VD, in 7, or VD plus thalidomide in 26 pts) for a median of 4 cycles (range 3-6), 2 patients received thalidomide plus dexamethasone (6-12 cycles). PBSC were collected after high-dose cyclophosphamide (2 g/sqm in 2 pts, 3 g/sqm in 11 pts, 4 g/sqm in 22 pts) plus G-CSF; plerixafor was administered in 4 pts. Three pts also received lenalidomide and dexamethasone to improve the depth of response before ASCT. At the time of conditioning, among 34 evaluable pts, 8/34 pts were in complete response/stringent complete response (CR/sCR), 19/34 in very good partial response (VGPR), 5/34 in partial response (PR) and 2/34 in stable disease (SD). The conditioning regimen consisted of melphalan 140 mg/sqm in 11 pts or 200 mg/sqm in 24 pts. A median number of 4.11 x10^6 CD34+ cells/Kg was reinfused (range 2.09-10.44). The most frequent complication was fever (9 pts) with gram negative bacteremia documented in 3/9 and gram positive bacteremia in 1/9. Other complications were represented by 1 case of atrial fibrillation and 3 cases of pneumonia and 1 case of VZV reactivation. All 35 pts achieved neutrophils recovery after a median of 12 days (range 8-25) and platelets recovery after a median of 13 days (range 8-45) after transplant. No grade 3-4 toxicities were recorded. No transplant-related mortality was recorded within 100 days post transplantation. Three months after ASCT, among 28 evaluable pts, 10/28 pts were in CR, 14/28 pts in VGPR and 4/28 pts in PR. Three pts underwent tandem ASCT. After a median follow-up of 32 months (range 3-96) among 33 evaluable pts, 20 experienced disease relapse and 7 deaths occurred. Median PFS and OS were 21 and 40 months.
Conclusion
Our data support the use of ASCT as an effective and safe first-line treatment approach also in elderly MM pts. A careful patient selection is needed to reduce the toxicity of the procedure.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, Elderly, ABMT
Abstract: PB1983
Type: Publication Only
Background
Aims
Methods
Results
Overall we analized 35 pts: 21 males and 14 females (median age 66, range 65-70); 23 had IgG MM, 4 had IgA MM and 8 had light chain MM. Induction therapy was bortezomib-based (bortezomib in combination with dexamethasone, VD, in 7, or VD plus thalidomide in 26 pts) for a median of 4 cycles (range 3-6), 2 patients received thalidomide plus dexamethasone (6-12 cycles). PBSC were collected after high-dose cyclophosphamide (2 g/sqm in 2 pts, 3 g/sqm in 11 pts, 4 g/sqm in 22 pts) plus G-CSF; plerixafor was administered in 4 pts. Three pts also received lenalidomide and dexamethasone to improve the depth of response before ASCT. At the time of conditioning, among 34 evaluable pts, 8/34 pts were in complete response/stringent complete response (CR/sCR), 19/34 in very good partial response (VGPR), 5/34 in partial response (PR) and 2/34 in stable disease (SD). The conditioning regimen consisted of melphalan 140 mg/sqm in 11 pts or 200 mg/sqm in 24 pts. A median number of 4.11 x10^6 CD34+ cells/Kg was reinfused (range 2.09-10.44). The most frequent complication was fever (9 pts) with gram negative bacteremia documented in 3/9 and gram positive bacteremia in 1/9. Other complications were represented by 1 case of atrial fibrillation and 3 cases of pneumonia and 1 case of VZV reactivation. All 35 pts achieved neutrophils recovery after a median of 12 days (range 8-25) and platelets recovery after a median of 13 days (range 8-45) after transplant. No grade 3-4 toxicities were recorded. No transplant-related mortality was recorded within 100 days post transplantation. Three months after ASCT, among 28 evaluable pts, 10/28 pts were in CR, 14/28 pts in VGPR and 4/28 pts in PR. Three pts underwent tandem ASCT. After a median follow-up of 32 months (range 3-96) among 33 evaluable pts, 20 experienced disease relapse and 7 deaths occurred. Median PFS and OS were 21 and 40 months.
Conclusion
Our data support the use of ASCT as an effective and safe first-line treatment approach also in elderly MM pts. A careful patient selection is needed to reduce the toxicity of the procedure.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, Elderly, ABMT