Apperley, J

Auner, H

Chaidos, A

Eccersley, L

Muffett, E

O'Boyle, F

Slade, D

Szydlo, R

English

Spiral - Imperial College Digital Repository

EBMT 2016 - Physicians Abstract (including Data and QualityManagement)Topic area: Disease - specific topicsTopic: 25. Multiple myelomaEBMT16-PH-1252The effect of body mass index and melphalan dose adjustments on outcomes in patients undergoing autologoushaematopoietic cell transplantation for multiple myeloma: a single-centre retrospective studyLydia Eccersley* 1, Richard Szydlo2, Edward Muffett2, Aristeidis Chaidos1, 2, Jane Apperley1, 2, Farah O'Boyle1, David Slade1, Holger Auner1, 21Department of Haematology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, 2Centre for Haematology,Department of Medicine, Imperial College London, London, United KingdomPreferred Presentation Method: Oral or Poster PresentationIntroduction: Despite the introduction of novel therapies, high-dose melphalan followed by autologous haematopoieticcell transplantation (AHCT) remains the standard of care for younger patients with multiple myeloma (MM). There arelimited data on the effects of increased body mass index (BMI) on outcomes from AHCT and, in particular, whether or notmelphalan dose adjustments should be made in patients with increased BMI. We therefore investigated the effect ofincreased BMI, and melphalan dose adjustments made for this, on outcomes from AHCT for MM. Material (or patients) and methods: We conducted a retrospective study on all patients undergoing their first AHCT forMM from 2003-2013, and categorised them according to their BMI (normal weight: BMI 18.5-24.9, overweight: BMI 25.0-29.9, obese: BMI 30.0-34.9 and severely obese: BMI>35.0). We investigated whether BMI group affected CD34+ cellcollection, neutrophil/platelet engraftment, transplant-related mortality (TRM), progression-free (PFS) and overall survival(OS) rates. We also investigated, in a subgroup of patients with increased BMI, whether melphalan dose adjustmentsaltered outcomes compared to those in whom no dose adjustments were made.Results: 320 patients were included: 96 (30%) were normal weight, 143 (45%) overweight, 59 (18%) obese and 22 (7%)were severely obese. There were no significant differences between BMI groups in numbers of CD34+ cells harvested ortransplanted.  Neutrophil and platelet engraftment times were also not significantly different. The 5-year OS rate was notsignificantly different between BMI groups (50.7% for normal weight, 60.9% for overweight, 57.2% for obese and 55% forseverely obese, p=0.97).Patients  were  then  divided  into  two  groups  according  to  scheduled  melphalan  dose  (200mg/m2,  n  =  223,  and  all  otherdoses,  predominantly  140mg/m2,  n=97).  The  median  age  of  those  scheduled  for  200mg/m2  was  lower  than  for  thosescheduled to receive lower doses (57 versus 66 years, p<0.0001), and a higher proportion of patients in the lower dosegroup  had  renal  and  cardiac  co-morbidities.  However,  there  was  no  significant  difference  in  2-year  PFS  (49%  versus52%, p=0.32) or 5-year OS rates (61% versus 49 %, p=0.26) between these groups.In 43 patients with BMI>27.8 (33% of a total of 132), the melphalan dose was adjusted by the transplant physicians to 85-96% of that scheduled. Comparison of the dose-adjusted with the non-adjusted group showed no differences in age, sexor  co-morbidities.  There  were  no  statistically  significant  differences  between  these  groups  in  neutrophil  (median  14.0versus 13.0 days, p=0.11) and platelet engraftment (median 16.0 versus 17.0 days, p=0.19), 1-year TRM (0% versus 1%,p=0.81), 2-year PFS (57.1% versus 47.8%, p=0.30) and 5-year OS (61.2% versus 55.3%, p=0.84).Conclusion: In MM patients undergoing high-dose melphalan with AHCT, increased BMI does not alter CD34+ cellharvest, time to engraftment, 1-year TRM, 2-year PFS or 5-year OS. Melphalan dose reductions in patients withincreased BMI do not appear to alter key transplant outcomes.  Would you like to apply for the Best Young Abstract Award ?: NODisclosure of Interest: None DeclaredKeywords: Autologous haematopoietic cell transplantation, Body mass index, Multiple myeloma, Obesity

The effect of body mass index and melphalan dose adjustments on outcomes in patients undergoing autologous haematopoietic cell transplantation for multiple myeloma: a single-centre retrospective study

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The effect of body mass index and melphalan dose adjustments on outcomes in patients undergoing autologous haematopoietic cell transplantation for multiple myeloma: a single-centre retrospective study

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