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

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.

Age is a prognostic factor even among patients with multiple myeloma younger than 66 years treated with high-dose melphalan: the IFM experience on 2316 patients

“…A more recent retrospective study did analyze patients under 50 years of age. 8 This study showed a better outcome for young patients when treated with standard doses of chemotherapy, but not if treated with high-dose melphalan.…”

Multiple Myeloma - A hospital based cross sectional study in Bangladesh

“…The 5-year relative survival rate for MM is around 35%. Survival is higher in younger people and lower in the elderly (Bergsagel et al 1979and Rodon 2002and Ludwig et al 2008. Relevant demographic studies of MM pertaining to our country are not available except for few sporadic cross sectional studies (Kibria et al 2010).…”

Cost-Effectiveness of Autologous Stem Cell Treatment as Compared to Conventional Chemotherapy for Treatment of Multiple Myeloma in India

“…Markov state transition probabilities of moving from one health state to another were computed using date on progression free survival, while the probability to die due to multiple myeloma was computed using the overall survival [18,19].…”