title: Survival and years of life lost in different age cohorts of patients with multiple myeloma.
abstract: 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.
authors.affiliation: Department of Medicine I, Center of Oncology and Hematology, Wilhelminenspital, Vienna, Austria. heinz.ludwig@wienkav.at
authors.forename: Heinz
authors.initials: H
authors.lastname: Ludwig
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bolejack
authors.forename: John
authors.initials: J
authors.lastname: Crowley
authors.forename: Joan
authors.initials: J
authors.lastname: Bladé
authors.forename: Jesus San
authors.initials: JS
authors.lastname: Miguel
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimizu
authors.forename: Ingemar
authors.initials: I
authors.lastname: Turesson
authors.forename: Jan
authors.initials: J
authors.lastname: Westin
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Patrizia
authors.initials: P
authors.lastname: Tosi
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: A Keith
authors.initials: AK
authors.lastname: Stewart
authors.forename: Brian
authors.initials: B
authors.lastname: Durie
mesh_terms: 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