Abstract

Background: Multiple myeloma (MM) predominantly affects older adults, and as the population ages, the incidence of MM is rising. Autologous stem cell  transplant (ASCT) is a standard treatment for eligible MM patients, but its application in elderly patients is limited due to comorbidities and increased treatment-related risks. This study evaluated the outcomes of ASCT in elderly MM patients at a single center in Taiwan.

Methods: This retrospective study included 32 MM patients who underwent ASCT at MacKay Memorial Hospital, Tamsui branch, Taiwan, between May  2016 and May 2024. Patients were divided into two age groups: < 65 years (22 patients, younger patients) and ≥ 65 years (10 patients, elderly patients). Clinical data, survival outcomes (overall survival [OS] and progression-free survival [PFS]), and adverse events were analyzed for statistical comparison.

Results: At amedian follow-up of 45 months, the median OS for the entire cohortwas not reached, with no significant difference between age groups (84 months in the younger group and not reached in the elderly group, p = 0.924). Median PFS was 19 months for the younger group and 36 months for the elderly group (p = 0.754). Among the most common adverse eventswere fever (71.9%), infection (56.3%), and diarrhea (78.1%). Younger patients had significantly higher rates of fever (86.4%) and infection (95.5%) compared to elderly patients (40% and 40%, respectively).

Conclusion: This study suggests that ASCT provides comparable survival outcomes for elderly and younger MM patients. Fewer and milder complications in the elderly group also suggested that age alone should not preclude elderly patients from ASCT. Further research is needed to refine treatment strategies for elderlyMMpatients.