Autologous Peripheral Blood SCT for Myeloma: Trends in Cause-Specific Mortality
Posted: Thursday, September 23, 2021
According to a study presented in Transplantation and Cellular Therapy, disease-specific mortality among some patients with multiple myeloma appears to have declined in recent years. The prospective cohort study examined cause-specific mortality among patients who had received autologous peripheral blood stem cell transplantation (SCT) between 1989 and 2014.
“Although primary disease remains the major cause of late mortality, we observed a significant temporal decline in myeloma-, infection-, and cardiac-related late mortality over the past 25 years,” concluded Smita Bhatia, MD, of the University of Alabama at Birmingham, and colleagues.
The study included 1,906 patients who were sourced from the Blood or Marrow Transplant Survivor Study. Follow-up occurred over a median of 9.2 years. A total of three eras of treatment were determined based on changing standards of care: before 2000, prior to the implementation of thalidomide treatment; between 2000 and 2005, thalidomide treatment; and between 2006 and 2014, lenalidomide treatment. Among all patients who survived at least 2 years, the 10-year overall survival rate was 45%.
The 10-year cumulative incidence of myeloma-related mortality was 33% versus 13% for non-myeloma–related deaths. However, disease specific mortality was found to be on the decline over time (subdistribution hazard ratio [SHR] 2000–2005 = 0.80, 95% confidence interval [CI] = 0.60–1.07; SHR 2006–2014 = 0.46, 95% CI = 0.34–0.62; referent group: before 2000). A decrease in mortality related to infections and cardiovascular disease was also observed (SHR 2000–2005 = 0.50, 95% CI = 0.29–0.85; SHR 2006–2014 = 0.35, 95%CI = 0.21–0.60; referent group: before 2000 and SHR 2000-–005 = 0.45, 95% CI = 0.20–0.99; SHR 2006–2014 = 0.41, 95% CI = 0.18–0.93; referent group: before 2000, respectively).
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
