This is an interesting question, since the median age of myeloma patients at time of diagnosis is 70 years. Are autologous stem cell transplants (SCT) still a treatment route that can or ought to be considered for this patient group? The answer is a solid yes, albeit with some caveats, as recently reported by a group from Medstar Georgetown University Hospital. Previous studies have already suggested that auto-SCT’s are safe for older patients and are associated with encouraging response rates.
The Georgetown team evaluated outcomes of 360 patients, all aged between 75-83 years, who underwent auto-SCT within 12 months from their multiple myeloma diagnosis between 2013 and 2017. This time period is important to note because the modern immunomodulators and proteasome inhibitors were already available. This patient group had the following characteristics:
Those interested in learning more about the Karnofsky scale can check out the following link.
Those readers interested in learning more about this scoring methodology you can click on this link. This link provides a handy ‘calculator’ that goes into more detail than the summary matrix shown above, but gives good insight as to the minutiae our transplant physicians get involved in.
Conclusions of this large study can be summarized as follows:
It good to know that auto-SCT that older patients [around 75 years of age] is a safe and effective treatment of their myeloma given that they have a reasonable level of physical fitness and a somewhat limited number of less severe other medical concerns.
about the author
I am a patient diagnosed in 2014 with primary plasma cell leukemia (pPCL), a rare and aggressive variant of multiple myeloma and have been very fortunate to find successful treatment at the division of Cellular Therapy at the Duke University Cancer Institute. My wife, Vicki, and I have two adult children and two grandsons who are the ‘lights of our lives’. Successful treatment has allowed Vicki and I to do what we love best : traveling the world, albeit it with some extra precautions to keep infections away. My career in the pharmaceutical industry has given me insights that I am currently putting to use as an advocate to lower drug pricing, especially prices for anti-cancer drugs. I am a firm believer that staying mentally active, physically fit, compliant to our treatment regimen and taking an active interest in our disease are keys to successful treatment outcomes.