Outcomes of Autologous Stem Cell Transplantation for Multiple Myeloma in Saudi Arabia

ABSTRACT

Background: In 2015, multiple myeloma (MM) represented 1% of all cancers and about 5% of hematologic malignancies in Saudi cancer registry. We conducted this large study because only small pilot studies have examined MM outcomes after autologous stem-cell transplantation (ASCT). The standard therapy for eligible patients is induction chemotherapy followed by ASCT.

Objectives: Determine the demographic characteristics of MM patients and the outcomes of ASCT.

Design: Retrospective.

Setting: Tumor registry database of major tertiary cancer care center in Riyadh.

Patients and methods: We identified patients with newly diagnosed MM who underwent ASCT from October 1997 to March 2015.

Main outcome measures: The demographic characteristics of MM patients and the outcomes of ASCT in the form of response evaluation, progression-free survival (PFS) and overall survival (OS).

Sample size: 169 patients with newly diagnosed MM.

Results: The median age at diagnosis was 51 years (range 23-69) and 100 (59.2%) were male. The most common immunoglobulin (Ig) subtype was IgG-kappa (80 patients; 47.6%). Most patients presented with advanced ISS stage III (75 patients; 47.5%). The cytogenetic analysis was documented in only 87 patients (51.4%); about half (48.3%) had normal cytogenetics by fluorescence in situ hybridization. Deletion 13 was present in 18.4% of patients. In post-induction therapy, 84 patients (50%) achieved a complete response, which increased to 78.1% (132 patients) after ASCT. The median PFS and OS post-transplantation were 30 and 202 months, respectively. Only one patient (<1%) died in the first 100 days after transplantation.

Conclusions: Our transplant eligible MM patients tend to be younger with a higher OS and a low ASCT-related mortality (<1%) than is reported internationally.

Limitations: Usual limitations of a retrospective analysis using registry-level data; no data on quality of life.