Page 264 - Haematologica Vol. 107 - September 2022

LETTER TO THE EDITOR
vival was 54.2% (13/24) (Figure 1).
The treatment landscape for elderly patients with both MM and NHL has dramatically improved in recent years. However, ASCT remains a significant contributor to im- proved outcomes in the elderly population with MM, and one of the few options for long term disease control for patients with R/R NHL.5-10 The main concern related to ASCT in the elderly has historically been transplant-re- lated mortality (TRM). With the improvement of supportive care, TRM rates in elderly patients have been declining. Our finding of 0% TRM is similar to that of prior reports in this age category.7,11 Additionally, in our study we observed a comparable 5-year mortality rate for elderly patients and their younger counterparts, despite a 15-year age dif- ference.
In contrast to above-mentioned reports, our elderly co- hort includes 80% patients from racial minority groups, predominantly Hispanic or African American. Studies have shown that Hispanics and African Americans are far less likely to undergo ASCT, despite an abundance of data
showing similar or better outcomes.12,13 Our study is the first to our knowledge to address the outcomes for elderly minority patients undergoing ASCT. It is worth noting that in the two large reports comparing outcomes of ASCT in minorities and Caucasians with MM, the upper age limit in minority cohorts was 75 years old, while Caucasian co- horts included patients up to age of 80.12,14 Similar to pa- tients with MM, favorable outcomes for elderly patients with NHL receiving ASCT with BEAM conditioning have been reported, with no reports in the literature on minor- ity elderly patients.15 This is of clinical importance as vari- ous studies have shown that minority patients with NHL have worse outcomes compared to Caucasians.16,17 This data suggests that elderly minority patients have two sep- arate variables contributing to a decreased chance of being offered ASCT. 26.4% of the Bronx’s population lives below the poverty line.18 Montefiore Medical Center is one of the largest providers of Medicaid and Medicare in New York State. Analysis of National Cancer Database (NCDB) showed that ASCT improved survival for MM patients from
Figure 1. Overall survival. Survival probablity of individual patient cohorts was plotted again time with control groups marked in blue and study groups marked in red.
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