Myeloma in patients under age 50 shows better survival

Ludwig H, Durie BG, Bolejack V, Turesson I, Kyle RA, Blade J, Fonseca R, Dimopoulos M, Shimizu K, San Miguel J, Westin J, Harousseau JL, Beksac M, Boccadoro M, Palumbo A, Barlogie B, Shustik C, Cavo M, Joshua D, Attal M, Sonneveld P, Crowley J.

Department of Medicine I, Wilhelminenspital, Vienna, Austria.

We analyzed the presenting features and survival in 1,689 patients with multiple myeloma aged <50>/= 50 years of age. 7,765 of the total 10,549 patients received conventional and 2,784 high-dose therapy. Young patients were more frequently male, had more favorable features such as low ISS and D/S stage as well as less frequently adverse prognostic factors including high CRP, low hemoglobin, increased serum creatinine and poor performance status. Survival was significantly longer in young patients (median 5.2 years versus 3.7 years; P<.001) both after conventional (median: 4.5 years versus 3.3 years; P<.001) or high-dose therapy (median: 7.5 years versus 5.7 years; P=.04). Ten-year survival rate was 19% after conventional and 43% after high-dose therapy in young, and 8% and 29%, respectively, in older patients. Multivariate analysis revealed age as an independent risk factor during conventional therapy, but not after autologous transplantation. Five of the 10 independent risk factors identified for conventional therapy were also relevant for autologous transplantation. After adjusting for normal mortality, lower ISS stage and other favorable prognostic features seem to account for the significantly longer survival of young patients with multiple myeloma with age remaining a risk factor during conventional therapy.

PMID: 18268097 [PubMed - as supplied by publisher]