Changing practice patterns in autologous transplantation at EBMT centers

Over the last 25 years, the number of autologous hematopoietic cell transplantations (auto-HCT) for the treatment of transplant-eligible patients with multiple myeloma (MM) has increased.

During the Virtual 46th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Patrick Hayden presented the results of a retrospective analysis of patients who underwent first auto-HCT for MM at EBMT centers between 1997 and 2018.¹

Methods

This retrospective analysis evaluated the trends in transplant use, patient selection, induction regimen, response to transplant, choice of mobilization regimen, stem cell doses, and survival over consecutive 5-year cohorts:

1. 1993–1997
2. 1998–2002
3. 2003–2007
4. 2008–2012
5. 2013–2017

All data were obtained from the EBMT registry.

Results

The study included 103,032 patients from 568 centers in 54 countries. Findings are reported in Table 1 and Figure 1.

Table 1. Study findings¹

Figure 1. Progression-free survival and overall survival rates at 24 and 36 months¹

OS, overall survival; PFS, progression-free survival. 

Conclusion

Over the last 25 years, the number of transplants has increased sevenfold, and the median age at transplant and the percentage of patients > 65 years at transplant has also increased. The choice of induction regimens has evolved, with a growing number of patients having received bortezomib-based triplet induction in the 2013─2017 cohort. A rise in the number and quality of responses and a significant improvement in progression-free survival and overall survival rates were observed, which supports the critical role of auto-HCT even in the novel agent era.