11 February 2025 : Original article
Retrospective Study to Compare Outcomes in 159 Patients Undergoing First Autologous Stem Cell Transplantation for Myeloma Treated with Melphalan 140 mg/m² or 200 mg/m²
Umut Yılmaz
1ABCDEF*, Şükran Erdem Nurcan 2BC, Deniz Özmen 1B, Ayşe Salihoğlu1AB, Ahmet Emre Eşkazan1ADE, Şeniz Öngören1AB, Zafer Başlar1BD, Teoman Soysal 1ADF, Muhlis Cem Ar1ADEF, Tuğrul Elverdi1ACDEF
DOI: 10.12659/AOT.947186
Ann Transplant 2025; 30:e947186
Table 1 Selected background features at the time of ASCT comparing patients groups receiving two different melphalan doses.
| Mel200 (n=130) | Mel140 (n=26) | Significance | |
|---|---|---|---|
| Male | 71 (54.6%) | 15 (57.6%) | |
| Female | 59 (45.4%) | 11 (42.4% | =0.77 |
| Age | Median: 56 (29–70) | Median: 58 (46–71) | =0.37 |
| Renal failure* | 0.7% | 42.3% | <0.001 |
| Age among those without renal failure | Median: 56 (29–70) | Median: 62 (54–71) | =0.03 |
| Karnofsky score | 90 (median) | 80 (median) | |
| Hospitalization for ASCT (days) | Median: 19 (14–28) | Median: 22 (20–34) | =0.003 |
| PMNL engraftment | Median: 10 days | Median: 10 days | =0.86 |
| HCT-CI | Median: 2 (0–5) | Median: 3 (1–7) | <0.001 |
| ISS stage 2 | 67 (51.5%) | 10 (38.5%) | |
| ISS stage 3 | 60 (46.1% | 16 (61.5%) | =0.15 |
| IgG | 78 (60%) | 11 (42.3%) | |
| IgA | 26 (20%) | 7 (26.9%) | |
| Light chain | 25 (19.2%) | 8 (30.8%) | =0.29 |
| High-risk genetics | 17 (13.1%) | 4 (15.4%) | =0.75 |
| 1 LoT VCD | 70 (53.8%) | 15 (57.7%) | |
| 1 LoT VAD | 53 (40.8%) | 9 (34.6%) | =0.61 |
| 2 LoT VCD | 37 (56.9%) | 7 (58.3%) | |
| 2 LoT VRD | 24 (36.9%) | 3 (25%) | =0.29 |
| Number of LOT** | |||
| 1 | 67 (51.5%) | 14 (53.8%) | |
| 2 | 54 (41.5%) | 5 (19.2%) | =0.43 |
| ≥3 | 9 (7%) | 7 (26.9%) | |
| Number of cycles | Median: 6 | Median: 7 | =0.09 |
| Bortezomib** | 110 (84.6%) | 24 (92.3%) | =0.3 |
| Lenalidomide** | 32 (24.6%) | 7 (26.9%) | =0.8 |
| VGPR/CR | 100 (76.9%) | 21 (80.7%) | =0.66 |
| Lenalidomide maint. | 36 (27.7%) | 6 (23.1%) | =0.63 |
| Mel200 – melphalan 200 mg/m; Mel140 – melphalan 140 mg/m; HCT-CI – hematopoietic cell transplantation-specific comorbidity index; ASCT – autologous stem cell transplantation; LoT – line of therapy; VCD – bortezomib-cyclophosphamide-dexamethazone; VRD – bortezomib-lenalidomide-dexamethazone. * Renal failure was defined as an estimated glomerular filtration rate of less than 50 ml/min (MDRD) based on local practice to reduce melphalan dose independent of patient performance or comorbidities. ** Before ASCT. | |||