Autologous Stem Cell Transplantation (ASCT) in patients with newly diagnosed Multiple Myeloma (NDMM) over 65 years

Abstracts APB appears after a median of 3 months (range 0,5 e 16). Among the 28 APB patients, 11 was treated with lenalidomide maintenance, while 17 stopped therapy after transplant. Three out of 11 maintenance patients (27%) shown APB disappearance, while 14 out of 17 no maintenance patients (82%; p 0,013) lost APB. No differences in OS and in PFS were seen, either in APB positive vs APB negative pts or in pts with persistence vs loss of APB. Conclusion: this data confirms that novel agents cause a very high proportion of APB positive pts and that prognostic advantage of APB patients is not to be taken for granted but need to be further investigated. Finally, lenalidomide, which is an immunomodulatory drug, causes persistence of APB in a small group of patients who underwent maintenance after ABMT, probably involved in sustaining the immune reconstitution.

both progression-free survival and overall survival. Figure 1. Conclusions: ASCT in patients with NDMM over 65 years is feasible, without differences in toxicity or efficacy between the groups analysed. Ageing with an excellent quality of life and lack of comorbidities is a usual NDMM population scenario that requires the completion of clinical trials like those that were performed in patients under 65 in our real world. Figure 1 Overall Survival from ASCT

PO-117 Autologous Stem Cell Transplantation (ASCT) in patients with newly diagnosed Multiple Myeloma (NDMM) over 65 years S. Cerdá, N. de, L. Heras, M. Fuertes, B. Ballina, V. Martinez-Robles, P. Escribano, J.-A. Rodriguez-García, F. Escalante Complejo asistencial universitario de león

Introduction: Eligibility of candidates of ASCT in NDMM patients is defined in most health institutions by the age at diagnosis diagnosed (generally under 65y) and not by biological or functional age. In the last 2 decades we have seen a substantial improvement in the prognosis of these patients, especially young people, based on the best induction schemes, more effective and less toxic, and an intensification to improve response with high dose chemotherapy supported by ASCT. Materials and Methods: Retrospective description and comparison of ASCT the characteristics of NDMM between 2009 and 2014 as older age groups 65 vs. less than or equal to 65 years. Table 1 Characteristics of Patients: 46 consecutive ASCT in 44 patients with NDMM at our institution between 2009 and 2014 were analysed. 30 patients were <65 years (median 57 years, range 46-65 a) and 14 patients> 65 (median 68, range 66-71 a) Most patients (52/54) have received induction treatment with Bortezomib based schemes (VelDex: 21, VTD: 17 and 9 with other schemes (schemes 5 with other Vel-Based (4: VRD, 1: CyBorDex) and 2 with conventional chemotherapy). There are no differences in induction scheme between groups. VelDex was used until 2013 and VTD/VRD in 2013-2014. Mobilisation and collection of peripheral blood progenitor cells (PBPC) are successfully without differences between groups. Results: Conditioning schemes administered were: 40 MEL200 procedures, MEL 140 in 1 patient, BuMel in 5 patients (3 in tandem setting and 2 as part of 2nd ASCT) Comparison of toxicities of the procedure. Table 2 Although follow-up of these patients is short, we have observed a similar efficacy results in rate and quality of responses and survival of

Table 1 Toxicities <65 y

AGE*

>65y

30 pts

14 pts

33 ASCTs

15 TASPEs

p

57 (46-65)

68 (66-71)

CD34 infunsed* ANC>100/mm3*

3 (1.8-5) 9 (7-11)

3.15 (2.3-3.9) 10 (9-10)

ns ns

ANC>500/mm3* plt>20000/mm3*

10 (8-12) 12 (8-22)

11 (9-12) 11 (10-14)

ns ns

19 (11-30) 21.2 (12-63)

14 (13-21) 20 (13-41)

ns ns

plt>50000/mm3* days of hospitalization* Red Cell Package Tx* Platelets Tx*

2 (0-10) 3 (1-7)

1 (0-2) 2 (1-4)

ns ns

Mucositis Grade* Number of febrile episodes*

1 (1-4) 1 (0-3)

1 (1-3) 1 (0-3)

ns ns

0

0

ns

TRM* *median (range)

15th International Myeloma Workshop, September 23-26, 2015

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