Multiple myeloma in elderly patients: prognostic factors and outcome.
OBJECTIVE
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.


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.
Anagnostopoulos
Athanasios
A
Department of Clinical Therapeutics, School of Medicine, University of Athens, Greece.
Gika
Dimitra
D
Symeonidis
Argyris
A
Zervas
Konstantinos
K
Pouli
Anastasia
A
Repoussis
Panagiostis
P
Grigoraki
Vassiliki
V
Anagnostopoulos
Nikolaos
N
Economopoulos
Theophanis
T
Maniatis
Alice
A
Dimopoulos
Meletios-Athanasios
MA
D000367:Age Factors; D000368:Aged; D000740:Anemia; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
D007770:L-Lactate Dehydrogenase