TY - JOUR
T1 - Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival
T2 - An analysis of 10 549 patients from the International Myeloma Working Group
AU - Ludwig, Heinz
AU - Durie, Brian G.M.
AU - Bolejack, Vanessa
AU - Turesson, Ingemar
AU - Kyle, Robert A.
AU - Blade, Joan
AU - Fonseca, Rafael
AU - Dimopoulos, Meletios
AU - Shimizu, Kazuyuki
AU - Miguel, Jesus San
AU - Westin, Jan
AU - Harousseau, Jean Luc
AU - Beksac, Meral
AU - Boccadoro, Mario
AU - Palumbo, Antonio
AU - Barlogie, Bart
AU - Shustik, Chaim
AU - Cavo, Michele
AU - Greipp, Philip R.
AU - Joshua, Douglas
AU - Attal, Michel
AU - Sonneveld, Pieter
AU - Crowley, John
PY - 2008/4/15
Y1 - 2008/4/15
N2 - 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.
AB - 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.
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U2 - 10.1182/blood-2007-03-081018
DO - 10.1182/blood-2007-03-081018
M3 - Article
C2 - 18268097
AN - SCOPUS:43249125513
SN - 0006-4971
VL - 111
SP - 4039
EP - 4047
JO - Blood
JF - Blood
IS - 8
ER -