Maximilian Merz1, Lina Jansen2, Felipe A Castro2, Jens Hillengass3, Hans Salwender4, Katja Weisel5, Christof Scheid6, Sabine Luttmann7, Katharina Emrich8, Bernd Holleczek9, Alexander Katalinic10, Alice Nennecke11, Christian Straka12, Christian Langer13, Monika Engelhardt14, Hermann Einsele15, Nicolaus Kröger16, Dietrich Beelen17, Peter Dreger3, Hermann Brenner18, Hartmut Goldschmidt19. 1. Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: maximilian.merz@med.uni-heidelberg.de. 2. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany. 3. Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany. 4. Asklepios Klinik Hamburg Altona, Hamburg, Germany. 5. Universitätsklinikum Tübingen, Tübingen, Germany. 6. Universitätsklinikum Köln, Köln, Germany. 7. Cancer Registry of Bremen, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany. 8. Cancer Registry of Rhineland-Palatinate, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany. 9. Saarland Cancer Registry, Saarbrücken, Germany. 10. Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany. 11. Hamburg Cancer Registry, Authority for Health and Consumer Protection, Hamburg, Germany. 12. Schön Klinik Starnberger See, Berg, Germany. 13. Universitätsklinikum Ulm, Ulm, Germany. 14. Universitätsklinikum Freiburg, Freiburg, Germany. 15. Universitätsklinikum Würzburg, Würzburg, Germany. 16. Interdisziplinäre Klinik für Stammzelltransplantation, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 17. Klinik für Knochenmarktransplantation des Universitätsklinikum Essen, Essen, Germany. 18. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany. 19. Medizinische Klinik V, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany.
Abstract
BACKGROUND: The aim of this study was to determine the value of upfront autologous transplantation (ASCT) in elderly patients (60-79 years) with myeloma. METHODS: We analysed relative survival (RS) of patients diagnosed in 1998-2011 and treated with ASCT within 12 months after diagnosis in Germany (n = 3591; German Registry of Stem Cell Transplantation) and compare RS with survival of myeloma patients diagnosed in the same years in Germany (n = 13,903; population-based German Cancer Registries). RESULTS: Utilisation of ASCT has increased rapidly between 2000-2002 and 2009-2011 (60-64years: 7.0-43.0%; 65-69 years: 6.6-23.7%; 70-79 years: 0.4-4.0%). Comparison of 5-year RS of patients from the general German myeloma population who have survived the first year after diagnosis with 5-year RS of patients treated with ASCT revealed higher survival for transplanted patients among all age groups (60-64: 59.2% versus 66.1%; 65-69: 57.4% versus 61.7%; 70-79: 51.0% versus 56.6%). RS increased strongly between 2003-2005 and 2009-2011 for the general German myeloma population (+8.5%) and for patients treated with ASCT (+11.8%). Differences in RS between these groups increased over time from +1.9% higher age-standardised survival in transplanted patients in 2003-2005 to 5.2% higher survival in 2009-2011. CONCLUSION: We conclude that upfront ASCT might be a major contributor to improved survival for elderly myeloma patients in Germany.
BACKGROUND: The aim of this study was to determine the value of upfront autologous transplantation (ASCT) in elderly patients (60-79 years) with myeloma. METHODS: We analysed relative survival (RS) of patients diagnosed in 1998-2011 and treated with ASCT within 12 months after diagnosis in Germany (n = 3591; German Registry of Stem Cell Transplantation) and compare RS with survival of myelomapatients diagnosed in the same years in Germany (n = 13,903; population-based German Cancer Registries). RESULTS: Utilisation of ASCT has increased rapidly between 2000-2002 and 2009-2011 (60-64years: 7.0-43.0%; 65-69 years: 6.6-23.7%; 70-79 years: 0.4-4.0%). Comparison of 5-year RS of patients from the general German myeloma population who have survived the first year after diagnosis with 5-year RS of patients treated with ASCT revealed higher survival for transplanted patients among all age groups (60-64: 59.2% versus 66.1%; 65-69: 57.4% versus 61.7%; 70-79: 51.0% versus 56.6%). RS increased strongly between 2003-2005 and 2009-2011 for the general German myeloma population (+8.5%) and for patients treated with ASCT (+11.8%). Differences in RS between these groups increased over time from +1.9% higher age-standardised survival in transplanted patients in 2003-2005 to 5.2% higher survival in 2009-2011. CONCLUSION: We conclude that upfront ASCT might be a major contributor to improved survival for elderly myelomapatients in Germany.
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