Trends in autologous stem cell transplantation for newly diagnosed multiple myeloma: Changing demographics and outcomes in European Society for Blood and Marrow Transplantation centres from 1995 to 2019

Dawn Swan*, Patrick J. Hayden, Dirk Jan Eikema, Linda Koster, Sandra Sauer, Didier Blaise, Emma Nicholson, Neil Rabin, Cyrille Touzeau, Jennifer Byrne, Anne Huynh, Jan J. Cornelissen, Victoria Potter, Edouard Forcade, Christopher Parrish, John Gribben, Marie Lorraine Chretien, Stephan Mielke, Tobias Gedde-Dahl, Péter ReményiPanagiotis Tsirigotis, Antoni Garcia Guiñón, Meral Beksac, Stefan Schönland, Ibrahim Yakoub-Agha

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)

Abstract

Multiple myeloma (MM) accounts for 10% of haematological malignancies. Overall survival (OS) has improved in recent years due to increased use of autologous stem cell transplantation (ASCT) in the treatment of newly diagnosed MM and the advent of novel agents, including proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies. To assess trends in ASCT including patient selection, choice of induction regimen, depth of response and survival, we performed a retrospective analysis of all patients undergoing first ASCT for MM in European Society for Blood and Marrow Transplantation centres between 1995 and 2019. A total of 117 711 patients across 575 centres were included. The number of transplants performed increased sevenfold across the study period. The median age increased from 55 to 61 years, and the percentage of patients aged >65 years rose from 7% to 30%. Use of chemotherapy-based induction fell significantly, being largely replaced by bortezomib-based regimens. The two-year complete response rate increased from 22% to 42%. The five-year progression-free survival and OS rates increased from 28% to 31% and from 52% to 69%, respectively. Transplant mortality fell from 5.9% to 1.5%. Ongoing advances in MM treatment may challenge the future role of ASCT. However, at the current time, ASCT remains central to the MM treatment paradigm.

Original languageEnglish
Pages (from-to)82-96
Number of pages15
JournalBritish Journal of Haematology
Volume197
Issue number1
Early online date15 Feb 2022
DOIs
Publication statusPublished - Apr 2022

Bibliographical note

Publisher Copyright: © 2022 British Society for Haematology and John Wiley & Sons Ltd.

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