Sobrevida de pacientes portadores de mieloma múltiplo submetidos ao transplante autólogo de células-tronco hematopoéticas.

Abstract

Although autologous hematopoietic stem cell transplantation has been performed in the context of multiple myeloma since the end of the 90’s, response to therapy and patient survival are not homogeneous between different patients. In order to understand the factors involved in therapy response degree and survival on autologous hematopoietic stem cell transplantation performed as first-line therapy, we conducted a retrospective analysis of myeloma multiple patients from a single Brazilian center. 140 medical records were evaluated, all patients treated with autologous hematopoietic stem cell transplantation between May 2004 and October 2017 were evaluated, excluding patients with prior transplant therapies or insufficient records data. Variables related to the International Staging System, Durie-Salmon staging, clinical presentation at diagnosis, regimen used for induction, number of treatment cycles, induction and transplant treatment response assessment were studied. Event-free survival and overall survival were calculated and associated to analyzed factors. Altogether, 137 patients were included in the study, with an average age of 52 years, 59,1% of them were male and 86,9% nonblack. Fifty-two patients (38%) died, 6 (4,4%) of these during autologous hematopoietic stem cell transplantation. overall survival was 63,8% and event-free survival was 25,1% in 5 years. overall survival univariate analysis, as confirmed by multivariate analysis, was smaller in patients with anemia at diagnosis (p = 0,006). Event-free survival, submitted to multivariate analysis, was smaller in patients treated with more than one line of induction chemotherapy. A positive response to induction therapy was the main factor related to a very good partial response and complete response to autologous hematopoietic stem cell transplantation (p = 0,001). Notwithstanding the great gap in knowledge over the successful myeloma multiple autologous hematopoietic stem cell transplantation factors, our data is similar to the ones found in literature, with anemia as an important independent prognostic factor to overall survival.