Multiple myeloma in octogenarians: Clinical features and outcome in the novel agent era
- 3 April 2012
- journal article
- research article
- Published by Wiley in European Journal of Haematology
- Vol. 89 (1), 10-15
- https://doi.org/10.1111/j.1600-0609.2012.01784.x
Abstract
Background Multiple myeloma (MM) affects mainly elderly persons and because the population of octogenarians increases, it is common to treat patients ≥80 years of age. These patients are often not included in clinical trials; thus, there is limited data on their characteristics and treatment outcome. Patients and methods We retrospectively analyzed 682 consecutive, unselected patients with newly diagnosed symptomatic myeloma who started treatment between January 1, 2003 and December 31, 2010. Results We identified 155 (23%) patients ≥ 80 years of age. Compared to patients P < 0.001), anemia (P = 0.006), low serum albumin (P = 0.001), and advanced ISS (P < 0.001). The median survival of patients ≥80 years was 22 months, and 14% died within 2 months from therapy initiation. The median survival of patients ≥80 years who received upfront novel agents was 26 vs. 17 months for those who did not. ECOG performance status ≤1 and frontline use of novel agents were independently associated with better survival. Response to first-line therapy was associated with improved survival (29 vs. 16 months, P = 0.017). Conclusions Patients ≥80 years of age present with features of advanced myeloma and impaired performance status. The addition of novel agents may improve their outcome, but careful assessment and prospective clinical trials targeting the population of elderly patients are needed.Keywords
This publication has 21 references indexed in Scilit:
- Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN)Blood, 2011
- Cyclophosphamide, thalidomide, and dexamethasone (CTD) as initial therapy for patients with multiple myeloma unsuitable for autologous transplantationBlood, 2011
- Thalidomide for previously untreated elderly patients with multiple myeloma: meta-analysis of 1685 individual patient data from 6 randomized clinical trialsBlood, 2011
- Multiple MyelomaNew England Journal of Medicine, 2011
- Patterns of Multiple Myeloma During the Past 5 Decades: Stable Incidence Rates for All Age Groups in the Population but Rapidly Changing Age Distribution in the ClinicMayo Clinic Proceedings, 2010
- Survival and Years of Life Lost in Different Age Cohorts of Patients With Multiple MyelomaJournal of Clinical Oncology, 2010
- Efficacy of Melphalan and Prednisone Plus Thalidomide in Patients Older Than 75 Years With Newly Diagnosed Multiple Myeloma: IFM 01/01 TrialJournal of Clinical Oncology, 2009
- Early Mortality After Diagnosis of Multiple Myeloma: Analysis of Patients Entered Onto the United Kingdom Medical Research Council Trials Between 1980 and 2002—Medical Research Council Adult Leukaemia Working PartyJournal of Clinical Oncology, 2005
- Review of 1027 Patients With Newly Diagnosed Multiple MyelomaMayo Clinic Proceedings, 2003
- CRITERIA FOR EVALUATING DISEASE RESPONSE AND PROGRESSION IN PATIENTS WITH MULTIPLE MYELOMA TREATED BY HIGH‐DOSE THERAPY AND HAEMOPOIETIC STEM CELL TRANSPLANTATIONBritish Journal of Haematology, 1998