Is Stem Cell Transplant Still Relevant in Today’s Treatment of Multiple Myeloma?
Posted: Thursday, July 26, 2018
Researchers at the University of California Davis Comprehensive Cancer Center (UC Davis) reported that autologous hematopoietic stem cell transplant (HSCT) offered a survival advantage of more than 20 months, based on data from an extensive retrospective study using the California Cancer Registry, published in the Journal of the National Cancer Institute. Even in an era of effective induction therapies for multiple myeloma, Aaron S. Rosenberg, MD, of UC Davis’ Division of Hematology and Oncology, and colleagues believe autologous HSCT should be considered for newly diagnosed patients with multiple myeloma.
In a UC Davis news release, Dr. Rosenberg expressed surprise that autologous HSCT had been used relatively sparingly. “It’s not for everyone,” he noted, “but that decision [to employ it or not] needs to be made with a keen eye toward the benefits and risks.”
Dr. Rosenberg’s team focused on data from 13,494 patients with multiple myeloma, younger than 80 years old, who were diagnosed in California between 1998 and 2012. A total of 20.8% of patients overall received autologous HSCT, but the procedure was more common in younger patients (37.6% of those younger than age 60) and less common (11.5%) in those between the ages of 60 and 79.
The median overall survival of the autologous HSCT group was 72.9 months from the time of the transplant, compared with about 50 months in the non–autologous HSCT group. Patients of all ages experienced improved survival. However, the team noted, worse survival was linked to transplants performed more than 12 months after diagnosis (compared with up to 12 months).