Risk Assessment for Newly Diagnosed Fit Young Patients with Multiple Myeloma in the Era of Novel Treatment Modalities: Should There Be Additional Factors Taken into Consideration??

Abstract

Introduction The optimal treatment for young patients with high-risk newly diagnosed multiple myeloma (NDMM) remains a challenge. Methods We retrospectively evaluated 58 NDMM patients younger than 55 years treated in our center from 2010 to 2021 with the current recommended protocols. Results After a median follow-up of 48 months, median overall survival (OS) was not reached; however, approximately 25% of them died within 4 years after diagnosis. Advanced disease stage, presence of extramedullary disease, elevated LDH, and less than very good remission before autologous hematopoietic stem-cell transplantation adversely affected patient survival. Based on these factors, we created a risk-assessment scoring system that sufficiently discriminated young NDMM patients at risk of poor outcome. The 4-year OS was superior for patients with zero to two factors to those with three to five factors (86% vs 44%, p <0.001). Conclusion The proposed scoring system could be reliably used at diagnosis and at interim disease evaluation in aiming for personalized treatment for young NDMM patients.

Management of Multiple Myeloma: A Review for General Practitioners in Oncology

“…MM is considered a disease of the elderly, but the reality is that up to 40% of newly diagnosed MM are in patients under 65, with approximately 15% in patients under 55 [1,33]. Currently, most clinical trials involve patients who are over 55, which limits the generalizability of the results to younger adults [34]. In addition, there is limited knowledge about the long-term efficacy of treatment regimens within this population.…”