Trends in autologous hematopoietic cell transplantation for multiple myeloma in Europe: increased use and improved outcomes in elderly patients in recent years

• Published in: Bone marrow transplantation (Basingstoke) Vol. 50; no. 2; pp. 209 - 215
• Main Authors: Auner, H W, Szydlo, R, Hoek, J, Goldschmidt, H, Stoppa, A M, Morgan, G J, Moreau, P, Attal, M, Marit, G, Russell, N, Brune, M, Cook, G, Sonneveld, P, Schönland, S, Garderet, L, Kröger, N
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2015; Nature Publishing Group
• Subjects: 692/308/2171; 692/699/1541/1990/804; Adult; Age; Age Factors; Age groups; Aged; Autografts; Bone marrow; Care and treatment; Cell Biology; Disease-Free Survival; Elderly patients; Europe - epidemiology; Female; Forecasts and trends; Health aspects; Hematology; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic Stem Cell Transplantation - trends; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple myeloma; Multiple Myeloma - mortality; Multiple Myeloma - therapy; Older people; original-article; Prognosis; Public Health; Registries; Remission; Risk analysis; Risk factors; Stem cell transplantation; Stem Cells; Survival; Survival Rate; Transplantation; Transplants & implants; Trends; Europe; United Kingdom
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2014.255

Autologous hematopoietic cell transplantation (AHCT) is a standard of care in multiple myeloma (MM) patients aged <65 years. To understand age-related trends in utilisation and outcome of AHCT, we analysed 53 675 MM patients who underwent a first AHCT in 31 European countries between 1991 and 2010. The number of patients undergoing AHCT increased for all age groups (<40, 40–49, 50–59, 60–64, 65–69 and ⩾70 years) throughout the observation period. The highest increase was observed for patients aged ⩾65 years, who accounted for 3% of AHCTs in 1991–1995 and for 18.8% of AHCTs in 2006–2010. Risk factors associated with survival over the entire observation period (
P
<0.001) were calendar period, remission status at AHCT, gender, disease duration before AHCT and age. Survival improved considerably more in older than in younger patients in recent years. In 2006–2010, median 2- and 5-year post-transplant survival ranged from 85.9 and 61.5% in patients <40 years to 80.2 and 49.7% in those ⩾70 years. All-cause day-100 mortality decreased throughout the observation period to ⩽2.4% for all age groups in 2006–2010. The results of this study demonstrate increased utilisation and safety of AHCT with improved post-transplant survival particularly in elderly MM patients in recent years in Europe.