Gender-Specific Aspects in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation: A Single-Center Experience

Abstract

Objective: Limited data exist on gender-specific aspects in hematologic malignancies and have been obtained mostly in non-Hodgkin lymphomas. The objective of this study was to investigate gender-specific aspects in patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT). Methods: A retrospective data analysis of 191 patients with MM who underwent ASCT was performed. Data collected from clinical records included age, sex, stage, induction therapy, outcome of induction, kind of stem cell mobilization, response to induction therapy and ASCT, cytogenetic aberrations, progression-free survival, and overall survival. Results: Eighty-one patients (42%) were female, whereas 110 patients were male (58%). No differences between female and male patients could be observed according to the international staging system (ISS) (e.g., ISS III: 14.8 vs. 17.3%), type of paraprotein, and cytogenetic aberrations (e.g., Del(13q): 32.7 vs. 28.9%). Five-year overall survival rates, when calculated from time to ASCT until death, were 27.2 and 36.4% and, when calculated from time to diagnosis until death, were 34.6 and 44.5%, respectively, and did not differ between groups according to ISS subgroups. Conclusion: Prognosis and baseline characteristics were identical and no differences could be observed between female and male patients with MM undergoing ASCT.

Sex Differences in Multiple Myeloma Biology but not Clinical Outcomes: Results from 3894 Patients in the Myeloma XI Trial

“…We hypothesized that this may have been due to the different therapy given in the Myeloma XI trial; however, there was no OS difference between the sexes in the Myeloma XI data for the CTD induction cohort and this regime was received by half of the patients in Myeloma IX. Other studies have identified either no difference in outcomes between the sexes 20 or a worse outcome for male patients 21 , 22 . Posch et al performed a single-center study looking at sex-specific aspects in 191 patients with MM undergoing ASCT and found no difference in prognosis 20 .…”

“…Other studies have identified either no difference in outcomes between the sexes 20 or a worse outcome for male patients 21 , 22 . Posch et al performed a single-center study looking at sex-specific aspects in 191 patients with MM undergoing ASCT and found no difference in prognosis 20 . In contrast, in an analysis of ~3000 patients from 9 different clinical trials, males had a worse OS (HR for females 0.83, 95% CI, 0.75-0.91) and interstingly sex distribution was significantly different among different ethnic subgroups; 67.1% of Hispanics were male, 59.6% of non-Hispanic Whites, 51.8% of non-Hispanic African-Americans, and 45.4.% of non-Hispanic others (p = 0.002) 21 .…”

Graft-Versus-Host Disease in Multiple Myeloma Patients Treated With Daratumumab After Allogeneic Transplantation

“…Other studies have identified either no difference in outcomes between the sexes [20] or a worse outcome for male patients [21,22]. Posch et al performed a single centre study looking at sex-specific aspects in 191 patients with MM undergoing ASCT and found no difference in prognosis [20]. In contrast, in an analysis of ~3000 patients from 9 different clinical trials, males had a worse OS (HR for females 0.83, 95% CI 0.75 -0.91) and sex distribution was also significantly different among different ethnic subgroups; 67.1% of Hispanics were male, 59.6% of non-Hispanic Whites, 51.8% of non-Hispanic African-Americans and 45.4.% of non-Hispanic others (p = 0.002) [21].…”

“…We hypothesised that this may have been due to the different therapy given in the Myeloma XI trial, however, there was no OS difference between the sexes in the Myeloma XI data for the CTD induction cohort and this regime was received by half of the patients in Myeloma IX. Other studies have identified either no difference in outcomes between the sexes [20] or a worse outcome for male patients [21,22]. Posch et al performed a single centre study looking at sex-specific aspects in 191 patients with MM undergoing ASCT and found no difference in prognosis [20].…”

Gender and the length of time since autologous hematopoietic stem cell transplantation—What is their influence on the immune reconstitution in multiple myeloma patients?

“…No information was found in the literature whether the lack of statistically significant differences between females and males in the length of time since the diagnosis until the first transplantation and the length of time since the diagnosis until the recent transplantation observed in the current study was also the case in the other populations of MM patients studied so far. Although Posch et al [22] emphasised in the title of their article the gender-specific aspects in patients with MM, they presented a median length of time since the diagnosis until the transplantation for all the studied patients, irrespective of gender. Also Htut et al [23], Chakraborty et al [24], Sweiss et al [25], Dhakal et al [26], and Alegre et al [27] presented the length of time since the diagnosis until the first transplantation irrespective of gender.…”