MM-317 Non-Cryopreserved Hematopoietic Stem Cells Autotransplantation in Patients With Multiple Myeloma (MM) Aged 65 and Older

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 23; p. S489
• Main Authors: Moufid, Nassima, Sraidi, Sofia, Benmoussa, Amine, Lamchahab, Mouna, Cherkaoui, Siham, Khoubila, Nissrine, Qachouh, Meryem, Madani, Abdellah, Rachid, Mohamed
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2023
• Subjects: elderly; multiple myeloma; non-cryopreserved autotransplants; MM; multiple myeloma; elderly; non-cryopreserved autotransplants
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01434-9

Hematopoietic stem cell transplantation (HSCT) without freezing in patients treated for MM and aged over 65 years results in improved complete response (CR) rates and prolonged overall survival. HSC transplantation without freezing is frequently used in resource-limited settings.
The objective is to report the experience of the hematology department in the 20 Aout Hospital of Casablanca with HSCT without cryopreservation in patients with MM over 65 years.
This was a retrospective study at the Oncology hematology department in Casablanca. The study included patients treated for MM aged 65 and over who have received induction chemotherapy and were eligible for transplantation. Twenty-four patients were included from 2016 to 2022; the median age was 65.5 years (65-68); the sex ratio M/F was 1.3. The MM was predominantly of the IgG kappa type (79%). 17 (72%) patients were assessed by the ISS score, of which 12 (70%) assessed patients had an ISS prognosis score of III. The induction Protocol was CTD for 18(75%) patients, VTD for 5 (21%) patients, and one patient was treated with VCD. The therapeutic response before the transplant was a CR for 5 (21%) patients, a very good partial response (VGPR) for 14 (58%) patients, and a partial response (PR) for 5 (21%) patients. Mobilizations were performed using G-CSF at a rate of 10 ug/kg. 22 (92%) patients had a single apheresis sample, and 2 (8%) had two samples. The median richness of the autologous transplantation was 10.08 106 CD34/Kg (1.26-19.1). No allergic reaction was noted during reinjection. During the aplasia, 13 (57%) patients presented with infection, including 4 (31%) patients with diarrhea, 2 patients (15%) with a pulmonary infection, and 7 (54%) infections of undetermined origin. The median duration of aplasia was 10 days. At a follow-up of 5 years, the CR rate was 50%, with 10 (42%) with VGPR and PR (4%), with a mortality rate of 4% linked to transplantation.
Autologous HSCT without cryopreservation among the elderly remains a reasonable choice in our context to limit delay and reduce hospitalization costs. Elderly patients are predisposed to toxic effects. The toxic effects were comparable to younger patients.