title: Multiple myeloma in the elderly: clinical features and response to treatment in 113 patients.
abstract: BACKGROUND
  Considering the conflicting results of the few reports on geriatric MM patients and the increasing relevance of the problem, we analyzed a series of 113 patients over 64 years of age treated with conventional chemotherapy.
  
  
  METHODS
  The median age was 71 (range 65-92). Stage IA, IIA, IIIA and IIIB patients numbered 28, 33, 45 and 7, respectively. The M component was IgG in 73 patients (65%), IgA in 30 (26%), IgD in 3 (3%), light chain in 5 (4%); no monoclonal component was detected in 2 (2%) cases. Sixty-three patients showed symptomatic skeletal disease. Melphalan/prednisone (MP) was the first-line treatment in 84 patients (74%). Patients were grouped according to age (> 64 < or = 74; > or = 75) in order to carry out analysis.
  
  
  RESULTS
  Seventy-eight cases (69%) showed a sizable reduction in the tumor mass; objective and partial response was achieved in 57 (50%) and 21 (19%) patients, respectively. Patients with stage I-II disease fared significantly better than stage III patients (median survival: 70 vs 38 months; p = 0.017). Response to first-line treatment correlated with overall survival; patients with responsive or refractory disease had median survival rates of 64 and 20 months, respectively (p = 0.0001).
  
  
  CONCLUSIONS
  Neither patients above nor below 75 years of age showed any difference in presentation features or in response to treatment. These results suggest that advanced age should not be considered a major obstacle to active treatment.
authors.affiliation: Department of Internal Medicine (Chair of Hematology and Medical Pathology B), University of Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Clavio
authors.forename: S
authors.initials: S
authors.lastname: Casciaro
authors.forename: A M
authors.initials: AM
authors.lastname: Gatti
authors.forename: M
authors.initials: M
authors.lastname: Spriano
authors.forename: F
authors.initials: F
authors.lastname: Bonanni
authors.forename: A
authors.initials: A
authors.lastname: Poggi
authors.forename: E
authors.initials: E
authors.lastname: Vallebella
authors.forename: D
authors.initials: D
authors.lastname: Pietrasanta
authors.forename: E
authors.initials: E
authors.lastname: Prencipe
authors.forename: R
authors.initials: R
authors.lastname: Goretti
authors.forename: R
authors.initials: R
authors.lastname: Vimercati
authors.forename: E
authors.initials: E
authors.lastname: Rossi
authors.forename: B
authors.initials: B
authors.lastname: Masoudi
authors.forename: R
authors.initials: R
authors.lastname: Ghio
authors.forename: P
authors.initials: P
authors.lastname: Boccaccio
authors.forename: S
authors.initials: S
authors.lastname: Ricciardi
authors.forename: E
authors.initials: E
authors.lastname: Damasio
authors.forename: M
authors.initials: M
authors.lastname: Gobbi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents