title: Age is a prognostic factor even among patients with multiple myeloma younger than 66 years treated with high-dose melphalan: the IFM experience on 2316 patients.
abstract: Age is a strong prognostic factor in multiple myeloma. The overall survival is shorter in patients older than 66 years, and even shorter in those older than 75 years. Whether age is also a prognostic parameter in patients younger than 66 years treated homogeneously with intensive approaches is unknown. To address this issue, we retrospectively analyzed a series of 2316 patients treated homogeneously with 3-4 cycles of induction chemotherapy followed by a high-dose melphalan course, without any consolidation or maintenance. We show that patients older than 60 years have a statistically significant shorter overall survival. The analysis of prognostic parameters did not show a higher incidence of high-risk cytogenetics, but a higher incidence of International Staging System (ISS) stages 2 and 3, mainly due to higher β2-microglobulin levels. This study is the first to demonstrate the impact of age in the outcome of 'young' patients with multiple myeloma, and suggests that this parameter should be included in the stratification factors for future prospective clinical trials.
authors.affiliation: Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse Department of Hematology, University Hospital, Dijon.
authors.forename: Marie-Lorraine
authors.initials: ML
authors.lastname: Chretien
authors.affiliation: Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hebraud
authors.affiliation: Service d'Epidémiologie, CHU Toulouse.
authors.forename: Valérie
authors.initials: V
authors.lastname: Cances-Lauwers
authors.affiliation: Department of Hematology, University Hospital, Nancy.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Hulin
authors.affiliation: Department of Hematology, University Hospital, Bordeaux.
authors.forename: Gerald
authors.initials: G
authors.lastname: Marit
authors.affiliation: Department of Hematology, University Hospital, Lille;
authors.forename: Xavier
authors.initials: X
authors.lastname: Leleu
authors.affiliation: Department of Hematology, University Hospital, Lyon.
authors.forename: Lionel
authors.initials: L
authors.lastname: Karlin
authors.affiliation: Department of Hematology, University Hospital, Toulouse.
authors.forename: Murielle
authors.initials: M
authors.lastname: Roussel
authors.affiliation: Department of Hematology, Institut Paoli Calmette, Marseille.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Stoppa
authors.affiliation: CIC Inserm 0802, Centre Hospitalier Universitaire, Poitiers.
authors.forename: Francois
authors.initials: F
authors.lastname: Guilhot
authors.affiliation: Department of Hematology, University Hospital, Rennes.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamy
authors.affiliation: Department of Hematology, University Hospital, St-Antoine, Paris.
authors.forename: Laurent
authors.initials: L
authors.lastname: Garderet
authors.affiliation: Department of Hematology, University Hospital, Grenoble.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Pegourie
authors.affiliation: Department of Hematology, University Hospital, Angers.
authors.forename: Mamoun
authors.initials: M
authors.lastname: Dib
authors.affiliation: Department of Hematology, Centre Léon Bérard, Lyon.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sebban
authors.affiliation: Department of Hematology, Centre Becquerel, Rouen.
authors.forename: Pascal
authors.initials: P
authors.lastname: Lenain
authors.affiliation: Department of Hematology, University Hospital, Bobigny.
authors.forename: Sabine
authors.initials: S
authors.lastname: Brechignac
authors.affiliation: Department of Hematology, University Hospital, Amiens.
authors.forename: Bruno
authors.initials: B
authors.lastname: Royer
authors.affiliation: Department of Hematology, Departmental Hospital, Dunkerque.
authors.forename: Marc
authors.initials: M
authors.lastname: Wetterwald
authors.affiliation: Department of Hematology, University Hospital, Nice.
authors.forename: Laurence
authors.initials: L
authors.lastname: Legros
authors.affiliation: Department of Hematology, Departmental Hospital, Annecy.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Orsini-Piocelle
authors.affiliation: Department of Hematology, Departmental Hospital, Chalon.
authors.forename: Laurent
authors.initials: L
authors.lastname: Voillat
authors.affiliation: Department of Hematology, Departmental Hospital, Pau.
authors.forename: Xavier
authors.initials: X
authors.lastname: Delbrel
authors.affiliation: Department of Hematology, University Hospital, Dijon.
authors.forename: Denis
authors.initials: D
authors.lastname: Caillot
authors.affiliation: Department of Hematology, University Hospital, Caen.
authors.forename: Margaret
authors.initials: M
authors.lastname: Macro
authors.affiliation: Department of Hematology, University Hospital, Lille;
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
authors.affiliation: Department of Hematology, University Hospital, Toulouse.
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.affiliation: Department of Hematology, University Hospital, Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Moreau
authors.affiliation: Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse avet-loiseau.h@chu-toulouse.fr corre.j@chu-toulouse.fr.
authors.forename: Hervé
authors.initials: H
authors.lastname: Avet-Loiseau
authors.affiliation: Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse avet-loiseau.h@chu-toulouse.fr corre.j@chu-toulouse.fr.
authors.forename: Jill
authors.initials: J
authors.lastname: Corre
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D060828:Induction Chemotherapy; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan
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