Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival: an analysis of 10 549 patients from the International Myeloma Working Group
Open Access
- 15 April 2008
- journal article
- research article
- Published by American Society of Hematology in Blood
- Vol. 111 (8), 4039-4047
- https://doi.org/10.1182/blood-2007-03-081018
Abstract
We analyzed the presenting features and survival in 1689 patients with multiple myeloma aged younger than 50 years compared with 8860 patients 50 years of age and older. Of the total 10 549 patients, 7765 received conventional therapy and 2784 received high-dose therapy. Young patients were more frequently male, had more favorable features such as low International Staging System (ISS) and Durie-Salmon stage as well as less frequently adverse prognostic factors including high C-reactive protein (CRP), low hemoglobin, increased serum creatinine, and poor performance status. Survival was significantly longer in young patients (median, 5.2 years vs 3.7 years; P < .001) both after conventional (median, 4.5 years vs 3.3 years; P < .001) or high-dose therapy (median, 7.5 years vs 5.7 years; P = .04). The 10-year survival rate was 19% after conventional therapy and 43% after high-dose therapy in young patients, 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. A total of 5 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.Keywords
This publication has 31 references indexed in Scilit:
- Recent major improvement in long-term survival of younger patients with multiple myelomaBlood, 2008
- Patterns of Survival in Multiple Myeloma: A Population-Based Study of Patients Diagnosed in Sweden From 1973 to 2003Journal of Clinical Oncology, 2007
- Chromosomal abnormalities of young multiple myeloma patients (<45 yr) are not different from those of other age groups and are independent of stage according to the International Staging SystemEuropean Journal of Haematology, 2006
- Impact of age on survival after intensive therapy for multiple myeloma: a population‐based study by the Nordic Myeloma Study GroupBritish Journal of Haematology, 2006
- Prognostic factors for survival after autologous transplantation: a single centre experience in 133 multiple myeloma patientsBone Marrow Transplantation, 2004
- Regression models for relative survivalStatistics in Medicine, 2003
- Autologous stem cell transplantation in multiple myeloma patients <60 vs ⩾60 years of ageBone Marrow Transplantation, 2003
- Review of 1027 Patients With Newly Diagnosed Multiple MyelomaMayo Clinic Proceedings, 2003
- Stage 0 to stage III breast cancer in young womenJournal of the American College of Surgeons, 2000
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958