title: Survival of multiple myeloma patients aged 65-70 years in the era of novel agents and autologous stem cell transplantation. A multicenter retrospective collaborative study of the Japanese Society of Myeloma and the European Myeloma Network.
abstract: Novel agents such as thalidomide, lenalidomide and bortezomib have dramatically changed the treatment paradigm of multiple myeloma (MM). However, it is not clear whether these agents improve the prognosis of elderly patients who have undergone autologous stem cell transplantation (auto-SCT). We retrospectively analyzed the outcome of 318 newly diagnosed patients aged 65–70 years who were treated between January 1, 2004, and December 31, 2009. As initial therapy, 192 patients were treated with conventional chemotherapy,88 with novel agent-containing regimens, 21 with conventional chemotherapy plus auto-SCT and the remaining 17 with novel agents plus auto-SCT. The median progression-free survival was 19.1, 24.5, 26.8 and 35.2 months, respectively, and the 5-year overall survival (OS) was 40, 62, 63 and 87%, respectively. Initial therapy with novel agents (p < 0.001) or auto-SCT (p < 0.02) significantly improved OS compared with the group without these treatment modalities. Salvage therapy with novel agents also significantly improved survival after relapse compared with conventional chemotherapy alone (p < 0.04). In a multivariate analysis, the use of novel agents was an independent prognostic factor significantly associated with extended OS(p < 0.003). These results indicate that novel agents and auto-SCT had a major impact on OS in eligible patients in this subgroup of MM.
authors.forename: Shuji
authors.initials: S
authors.lastname: Ozaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Harada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saitoh
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shimazaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Itagaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Asaoku
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Takaaki
authors.initials: T
authors.lastname: Chou
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yoshiki
authors.forename: Kenshi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murakami
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Hayashi
authors.forename: Roberto
authors.initials: R
authors.lastname: Mina
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D015507:Drugs, Investigational / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D011719:Pyrazines / Q000008:administration & dosage; D012189:Retrospective Studies; D016879:Salvage Therapy; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D001897:Boronic Acids; D015507:Drugs, Investigational; D047428:Protein Kinase Inhibitors; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide