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Cellular Therapy and Transplantation (CTT)
Volume 6, Number 3
High dose therapy (HDT) with autologous stem cell support is established as first line treatment in patients under 65 years. A population based study conducted by Nordic Myeloma Study Group 1994-1997 in Norway, Sweden and Denmark showed a median overall survival of 63 months in patients ≤60 years who received HDT, versus 44 months in historical controls. Since this investigation a number of new drugs have been introduced in the treatment of these patients, in particular as second line and later therapy. Therefore, a goal of our present study was a population based investigation in south east Norway (population 2,9 mill.) of the outcome of HDT in multiple myeloma in the period 2001-2010.
Patients and methods
A search in the patient administrative system of Oslo University Hospital showed that 366 patients with multiple myeloma ≤65 years with indication for start of chemotherapy had been registered from 01.01.2001 until 31.12.2009 (≤60 years: 241 patients, 61-65 years: 125 patients).
In patients ≤60 years 218/241 patients received HDT (88,5%). Median overall survival in this group was 82,2 months v.s. 23,9 months in the non HDT group. In patients 61-65 years 80/125 patients received HDT (64,5%). Median overall survival in the HDT group was 60,1 months and 28,2 months in the non-HDT group.
In this unselected, population based patient material median survival was 82,2 months in patients ≤60 years, which is approximately 20 months longer that what was found in the preceding Nordic study. It is assumed that this result reflects the impact of new drugs. The main reason for not giving HDT was comorbidity (90%) (insufficient stem cell harvest (6%) and patient refusal (4%)). Patients not receiving HDT is therefore a strongly negatively selected group.
Multiple myeloma, high dose therapy, survival, population-based study.