Factors useful for predicting survival of myeloma patients in everyday practice. A 10-year study of 148 patients older than 55 years.
OBJECTIVE
The objective of this study was to identify prognostic factors in a uniform population of older patients with myeloma.


METHODS
Thirty-one study centers in France included 148 patients who were older than 55 years at diagnosis and were followed up until death or for at least 10 years. The following tests were available for all patients: blood cell counts; serum, and urinary protein electrophoresis; and serum levels of creatinine, calcium, beta2 microglobulin (beta2m), lactic dehydrogenase (LDH), and C-reactive protein (CRP).


RESULTS
Mean age was 71.9 years, median survival was 34 months, and mean survival was 47 months. In the univariate analysis, factors significantly associated with higher mortality were male gender (odds ratio [OR], 1-2.12), age older than 70 years (OR, 1.10-2.28), serum albumin<30 g/l (OR, 1.16-3.28), serum creatinine>100 micromol/l (OR, 1.34-2.81), beta2m>6 mg/l (OR, 1.78-4), CRP>6 mg/l (OR, 1.44-3.06), hemoglobin<10 g/dl (OR, 1.8-2.23). In the multivariate analysis, only two factors significantly predicted a higher risk of death: beta2m>6 mg/l (OR=2.439 [1.59-3.76]) and CRP>6 mg/l (OR=1.76 [1.18-2.63). beta2m level was >6 mg/l in 41 (27.7%) patients and CRP was >6 mg/l in 61 (43.6%) patients. Other potential prognostic factors such as chromosome 13 deletion were not investigated because they were not available for all study patients.


CONCLUSIONS
The strength of this study is the 10-year follow-up in a uniform patient cohort. beta2m and CRP independently predicted the risk of death.
Chombart
Béatrice
B
CHU de Reims-France, Rheumatology Department, Sébastopol Teaching Hospital, 48, rue de Sébastopol, 51092 Reims cedex, France.
Lemoussu
Laurence Gagneux
LG
Eschard
Jean-Paul
JP
Ackah-Miezan
Stanley
S
Novella
Jean-Luc
JL
Brochot
Pascal
P
Pignon
Bernard
B
Etienne
Jean-Claude
JC
D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012307:Risk Factors; D001613:beta 2-Microglobulin / Q000097:blood
D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D011239:Prednisolone; D003404:Creatinine; D008558:Melphalan