title: Impact of age on survival after intensive therapy for multiple myeloma: a population-based study by the Nordic Myeloma Study Group.
abstract: The value of intensive therapy, including autologous stem cell transplantation, in newly diagnosed myeloma patients >60 years is not clear. We evaluated the impact of age (<60 years vs. 60-64 years) on survival in a prospective, population-based setting and compared survival with conventionally treated historic controls. The prospective population comprised 452 patients registered between 1998 and 2000. Of these, 414 received intensive therapy. The historic population, derived from our most recent population-based study on conventional therapy, comprised 281 patients. Of these, 243 fulfilled our eligibility criteria for intensive therapy. For patients undergoing intensive therapy it was found that two factors, beta-2-microglobulin and age <60 years vs. 60-64 years, had independent prognostic impact on survival. However, compared with the historic controls a survival advantage was found both for patients <60 (median 66 months vs. 43 months, P < 0.001) and 60-64 years (median 50 months vs. 27 months; P = 0.001). We conclude that in a population-based setting higher age adversely influences outcome after intensive therapy. Our results indicate that intensive therapy prolongs survival also at age 60-64 years but with less superiority than in younger patients.
authors.affiliation: Lund University Hospital, Lund, Sweden. stig.lenhoff@skane.se
authors.forename: Stig
authors.initials: S
authors.lastname: Lenhoff
authors.forename: Martin
authors.initials: M
authors.lastname: Hjorth
authors.forename: Jan
authors.initials: J
authors.lastname: Westin
authors.forename: Lorentz
authors.initials: L
authors.lastname: Brinch
authors.forename: Bengt
authors.initials: B
authors.lastname: Bäckström
authors.forename: Kristina
authors.initials: K
authors.lastname: Carlson
authors.forename: Ilse
authors.initials: I
authors.lastname: Christiansen
authors.forename: Inger Marie
authors.initials: IM
authors.lastname: Dahl
authors.forename: Peter
authors.initials: P
authors.lastname: Gimsing
authors.forename: Jens
authors.initials: J
authors.lastname: Hammerström
authors.forename: Hans E
authors.initials: HE
authors.lastname: Johnsen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Juliusson
authors.forename: Olle
authors.initials: O
authors.lastname: Linder
authors.forename: Ulf-Henrik
authors.initials: UH
authors.lastname: Mellqvist
authors.forename: Ingerid
authors.initials: I
authors.lastname: Nesthus
authors.forename: Johan Lanng
authors.initials: JL
authors.lastname: Nielsen
authors.forename: Jon Magnus
authors.initials: JM
authors.lastname: Tangen
authors.forename: Ingemar
authors.initials: I
authors.lastname: Turesson
mesh_terms: D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; D001613:beta 2-Microglobulin; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan