Abstract
Abstract 4511
Autologous stem cell transplantation (ASCT) is used as an upfront and salvage therapy for multiple myeloma (MM). We assessed the prognostic value of pre-transplant co-morbidity on the transplant outcome.
We analyzed the data of 162 patients with MM who underwent single ASCT between 2004 and 2009 in our center. Pre-transplant co-morbidity was scored according to the hematopoietic cell transplant co-morbidity index (HCT-CI). Data were tabulated and statistical difference was calculated using t-test and Chi square test. Correlation coefficiency test was used to correlate HCI-CI with data of continuous variables. Probabilities of overall survival were analyzed using Kaplan-Meier analysis.
The median follow up after transplant was 23 months (range: 0.7–78). The median age at transplant was 60 years (range: 34–77), males were 64%. A total of 130 patients (80%) had transplant at ≤ 12 months from diagnosis. The proportion of IgG, IgA and free light chain subtypes was 54, 24 and 17% respectively. Durie Salmon stage at diagnosis was stage I (8%), II (12%), III (60%) respectively. The median HCT-CI was 2 (range: 0–8). HCT-CI was 0, 1–2, >2 in 27%, 32%, and 41% respectively. There was no significant correlation between HCT-CI and time to engraft or length of stay. Patients with HCT-CI of 0–2 (group 1; n= 95) and >2 (group 2; n=67) had a re-admission rate (within 30 days) of 13.7% and 21% respectively (p=0.23). Group 1 had non-relapse mortality (NRM) of 0% at 18 months, while group 2 had NRM of 2% and 2.5% at 6 months and 18 months respectively (p= 0.02). There was no significant difference in the OS; not reached and 60 months in group 1 and 2 respectively (p=0.3).
These data show that high pre-transplant HCT-CI is associated with higher NRM following ASCT for multiple myeloma. This finding needs to be validated in a large cohort of patients.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
