A Real-Life Study of Autologous Stem-Cell Transplantation in Patients with Multiple Myeloma Older Than 65 Years in a Latin American Country

Introduction: The majority of patients with Multiple Myeloma (MM) are elderly (≥ 65 years). High dose chemotherapy followed by autologous stem cell transplantation (HDCT-ASCT) is the standard of care in patients younger than 65 years. This treatment option should be individualized in elderly patients, mainly due to increased toxicity. Goals: To assess the safety and outcome of HDCT-ASCT in real life in patients ≥ 65 years of age with a diagnosis of MM. Material and methods: Retrospective cohort study of consecutive patients with a diagnosis of MM according to the IMWG 2014 criteria from a single academic center in Argentina, undergoing their first HDTC-ASCT during the period 2008- 2018. Patients with plasma cell leukemia or light chain amyloidosis were excluded. Data was extracted from medical records and collected in an standardized case report form. Consolidation treatment and maintenance were used according to the standard of institutional care at the time of the ASCT. The patients ≥ 65 years old at HDCT-ASCT were compared with those below < 65 years treated in the same period. Response were categorized as: complete remission (CR), very good partial remission plus partial remission (VGPR/PR) and stable disease plus progression disease (EE/PD). Overall response rate (ORR) included CR, VGPR and PR. Overall survival (OS) and progression free survival (PFS) were calculated using the Kaplan and Meier method and compared using log-rank test. For survival, the risk ratio (HR) was calculated according to the multivariate Cox regression model. Transplant-related mortality (TRM) was analyzed with cumulative incidence curves of competitive risks. Values of p 70 years) and 171 patients