Survival and years of life lost in different age cohorts of patients with multiple myeloma.
OBJECTIVE
To assess the impact of age on outcome and to analyze the projected years of life lost in patients with multiple myeloma.


METHODS
Ten thousand five hundred forty-nine patients were evaluated; 6,996 patients were treated with conventional chemotherapy, and 3,553 patients were treated with high-dose therapy with autologous stem-cell transplantation.


RESULTS
Mean observed and relative overall survival times in the entire cohort were 3.7 and 3.9 years, respectively. Observed survival decreased steadily from 6.4 years in patients younger than age 50 years to 2.5 years in patients > or = age 80 years. A similar decrease was noted for relative survival. Higher age correlated significantly with higher International Staging System (ISS) stage. Relative excess risk of death differed significantly between 10-year age cohorts beginning from age 40 years (P < .001 for age 50 to 59 v age 40 to 49, P < .001 for age 60 to 69 v age 50 to 59, P < .001 for age 70 to 79 v age 60 to 69, and P = .009 for age > or = 80 v 70 to 79). The average years of life lost per patient was 16.8 years in the entire patient cohort and decreased steadily from 36.1 years in patients younger than 40 years old to 4.6 years in patients > or = age 80 years.


CONCLUSIONS
Age is associated with higher ISS stage and is an important risk factor for early mortality. Survival declined continuously by each decade from age 50 to age > or = 80 from more than 6 to less than 3 years. The average of years of life lost in patients with myeloma is higher than in many other cancers and amounts to more than 30 years in patients younger than 40 years old but decreases to less than 5 years in patients age 80 years or older.
Ludwig
Heinz
H
Department of Medicine I, Center of Oncology and Hematology, Wilhelminenspital, Vienna, Austria. heinz.ludwig@wienkav.at
Bolejack
Vanessa
V
Crowley
John
J
Bladé
Joan
J
Miguel
Jesus San
JS
Kyle
Robert A
RA
Rajkumar
S Vincent
SV
Shimizu
Kazuyuki
K
Turesson
Ingemar
I
Westin
Jan
J
Sonneveld
Pieter
P
Cavo
Michele
M
Boccadoro
Mario
M
Palumbo
Antonio
A
Tosi
Patrizia
P
Harousseau
Jean-Luc
JL
Attal
Michel
M
Barlogie
Bart
B
Stewart
A Keith
AK
Durie
Brian
B
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005060:Europe; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D009656:North America; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult