Multiple myeloma in elderly patients: prognostic factors and outcome

• Published in: European journal of haematology Vol. 75; no. 5; pp. 370 - 375
• Main Authors: Anagnostopoulos, Athanasios, Gika, Dimitra, Symeonidis, Argyris, Zervas, Konstantinos, Pouli, Anastasia, Repoussis, Panagiostis, Grigoraki, Vassiliki, Anagnostopoulos, Nikolaos, Economopoulos, Theophanis, Maniatis, Alice, Dimopoulos, Meletios-Athanasios
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.11.2005
• Subjects: age; Age Factors; Aged; Anemia; Clinical Enzyme Tests; elderly; Female; Humans; International Staging System; L-Lactate Dehydrogenase - blood; Male; multiple myeloma; Multiple Myeloma - diagnosis; Multiple Myeloma - mortality; Multiple Myeloma - pathology; Neoplasm Staging; Prognosis; prognostic factors; Survival Analysis; Treatment Outcome
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/j.1600-0609.2005.00532.x

:  Objectives: Purpose of this study was to compare prognostic factors and outcome of patients with multiple myeloma (MM) aged >70 yr at diagnosis with those of younger patients. We also applied the recently proposed International Staging System (ISS) for MM in these patients. Patients and methods: Among 1,162 newly diagnosed, symptomatic MM patients included in our database, 357 (31%) were >70 yr of age. Clinical and laboratory variables were evaluated in patients >70 yr and in younger patients and were assessed for possible correlation with survival in patients >70 yr of age. Results: Most clinical and laboratory features were similar in the two groups of patients but older patients presented more frequently with advanced ISS (P = 0.02). Despite similar response rates to primary treatment, younger patients survived longer than patients >70 yr of age (40 vs. 28 months, P = 0.001). There was a longer survival of younger patients than that of older patients diagnosed with ISS stage 1 (median 71 vs. 54 months, P = 0.007) and ISS stage‐2 patients (median: 38 vs. 26 months, P = 0.0008) but for patients with ISS stage 3 median survival was similarly poor in the younger and older age group (21 and 20 months, P = 0.283). Other variables associated with impaired prognosis were severe anemia, extensive bone marrow plasmacytosis and elevated serum LDH. Conclusions: Older patients with MM present more often with advanced ISS and have significantly shorter survival than younger patients. The ISS retained its prognostic significance within the group of elderly patients.