ICML 2019: Is Triplet Induction Therapy Safe for Older Patients With Multiple Myeloma?
Posted: Tuesday, June 25, 2019
In patients with multiple myeloma who are older than age 65, triplet induction therapy prior to autologous stem cell transplantation with high-dose melphalan conditioning appears to be safe and may provide outcomes similar to those seen in younger patients, according to a study conducted by Anna Czyz, MD, PhD, of Wroclaw Medical University, Wroclaw, Poland, and colleagues. However, they found that reducing the dose of melphalan conditioning to 100 mg/m2 was associated with a shorter progression-free survival. The study results were presented at the 2019 International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland (Abstract 527).
The researchers conducted a retrospective review of 162 newly diagnosed patients with multiple myeloma who were treated with triple induction therapy prior to their first autologous stem cell transplantation. The patients were categorized by age into group A (28–55 years; n = 46), B (56–64 years; n = 87), and C (65–71 years; n = 29). Participants received triplet combination therapy based on bortezomib (45%) or a combination of cyclophosphamide, thalidomide, and dexamethasone (55%) as first-line treatment prior to stem cell transplantation.
Melphalan at 200 mg/m2 was used as a preparative regimen in 83%, 79%, and 59% of patients in groups A, B, and C, respectively. A dose of 140 mg/m2 was used in 13%, 15%, and 30% of patients, respectively; the remaining patients received melphalan at 100 mg/m2.
The overall survival rates at 36 months were 79%, 83%, and 83% for patients in groups A, B, and C, respectively, and the 3-year progression-free survival rates were 53%, 45%, and 58%, respectively. A lack of response to first-line treatment and a melphalan dose lower than 140 mg/m2 were significantly associated with shorter progression-free survival.
Disclosure: The study authors’ disclosure information can be found at lymphcon.ch.