Contributions
Abstract: PB2182
Type: Publication Only
Background
In the UK five year overall survival in myeloma is estimated to be 47%, with 10 year overall survival (32.5%) ranking 6th lowest of the 20 most common cancers. The Beatson Oncology Centre serves the west of Scotland, encompassing some of the most deprived areas in Europe. Male life expectancy in Glasgow city is 73.4 years, while the average for Scotland is 77.1. Female life expectancy is 81.1 years in Glasgow (78.7 in Scotland). For comparison male and female life expectancy is 7 years greater in Sweden than Glasgow (male life expectancy 80.56 years and female life expectancy 84.09 years). Poor life expectancy is reflected in cancer survival rated.
Aims
In light of this, we were interested to see how this impacted on the overall survival of a group of unselected patients who were treated for relapsed multiple myeloma with a second autologous stem cell transplant (ASCT) at the Beatson Oncology Centre, Glasgow. Second autologous stem cell transplantation is ‘standard of care’ for our myeloma patients.
Methods
Patients were identified from data registration for EBMT. Electronic case records were retrospectively analysed for data retrieval for patients who underwent a second autograft between 1 January 2005 and 31 December 2015. Survival analysis was carried out by IBM SPSS Analytics.
Results
Of the 40 patients analysed 65% were male, 35% female. The average age was 59 (range 50-71). 57.5% of patients were diagnosed with IgG disease, 20% light chain, 15% IgA, 2.5% IgE, 2.5% non-secretory and 2.5% unrecorded.
The mean average time from diagnosis until first transplant was 12 months (range 5-61 months, median =8). Average hospital stay for the first transplant was 22.1 days (range 11-54, median =18). The average time until time to next treatment (TNT) from the first ASCT was 45.5 months (range 6-199, median =35.5). The mean average time until next second transplant was 55.65 months (range 20-208, median =46.5). Average hospital stay for the second transplant was 21.2 days (range 14-53, median =18).
The average time until next treatment from second transplant was 23.1 months (median =18, range 2-51). To date, 25% of patients have not required treatment post-transplant. Patients who did require treatment were generally retreated with a Lenalidomide based regimen (n=30) as per national Scottish guidance. 13 (32.5%) patients have died since their second treatment, the majority of progressive myeloma. Median overall survival post second transplant is 80.3%.
Conclusion
The ‘NCRI Myeloma X Relapse’ trial demonstrated the benefit of a second autologous stem cell transplant with three year overall survival as 80.3%. In our cohort, three year survival compared favourably at 81.9% (95% Confidence Interval [CI] 64.9-97.5). Projected five year survival is calculated to 59.4% (CI 42.8-47.5). Our data confirms the good outcome associated with a second autologous transplant in a non-trial unselected population despite background adverse life expectancy. It is therefore likely that our data can be extrapolated to our European populations with poor survival demographics.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Autologous bone marrow transplant, Multiple Myeloma, Relapse, Survival
Abstract: PB2182
Type: Publication Only
Background
In the UK five year overall survival in myeloma is estimated to be 47%, with 10 year overall survival (32.5%) ranking 6th lowest of the 20 most common cancers. The Beatson Oncology Centre serves the west of Scotland, encompassing some of the most deprived areas in Europe. Male life expectancy in Glasgow city is 73.4 years, while the average for Scotland is 77.1. Female life expectancy is 81.1 years in Glasgow (78.7 in Scotland). For comparison male and female life expectancy is 7 years greater in Sweden than Glasgow (male life expectancy 80.56 years and female life expectancy 84.09 years). Poor life expectancy is reflected in cancer survival rated.
Aims
In light of this, we were interested to see how this impacted on the overall survival of a group of unselected patients who were treated for relapsed multiple myeloma with a second autologous stem cell transplant (ASCT) at the Beatson Oncology Centre, Glasgow. Second autologous stem cell transplantation is ‘standard of care’ for our myeloma patients.
Methods
Patients were identified from data registration for EBMT. Electronic case records were retrospectively analysed for data retrieval for patients who underwent a second autograft between 1 January 2005 and 31 December 2015. Survival analysis was carried out by IBM SPSS Analytics.
Results
Of the 40 patients analysed 65% were male, 35% female. The average age was 59 (range 50-71). 57.5% of patients were diagnosed with IgG disease, 20% light chain, 15% IgA, 2.5% IgE, 2.5% non-secretory and 2.5% unrecorded.
The mean average time from diagnosis until first transplant was 12 months (range 5-61 months, median =8). Average hospital stay for the first transplant was 22.1 days (range 11-54, median =18). The average time until time to next treatment (TNT) from the first ASCT was 45.5 months (range 6-199, median =35.5). The mean average time until next second transplant was 55.65 months (range 20-208, median =46.5). Average hospital stay for the second transplant was 21.2 days (range 14-53, median =18).
The average time until next treatment from second transplant was 23.1 months (median =18, range 2-51). To date, 25% of patients have not required treatment post-transplant. Patients who did require treatment were generally retreated with a Lenalidomide based regimen (n=30) as per national Scottish guidance. 13 (32.5%) patients have died since their second treatment, the majority of progressive myeloma. Median overall survival post second transplant is 80.3%.
Conclusion
The ‘NCRI Myeloma X Relapse’ trial demonstrated the benefit of a second autologous stem cell transplant with three year overall survival as 80.3%. In our cohort, three year survival compared favourably at 81.9% (95% Confidence Interval [CI] 64.9-97.5). Projected five year survival is calculated to 59.4% (CI 42.8-47.5). Our data confirms the good outcome associated with a second autologous transplant in a non-trial unselected population despite background adverse life expectancy. It is therefore likely that our data can be extrapolated to our European populations with poor survival demographics.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Autologous bone marrow transplant, Multiple Myeloma, Relapse, Survival