title: Treatment of patients with multiple myeloma over 65 yr: more tolerability or better response?
abstract: OBJECTIVE
  Two-thirds of newly diagnosed patients with multiple myeloma (MM) are over 65 yr and/or physically unfit. Such patients are not eligible for high-dose chemotherapy or stem cell transplantation. The treatment aims in these patients should be to prolong survival by obtaining the best possible response, while maintaining good tolerability. The aim of our study was to evaluate the response to treatment and treatment-related toxicities in patients treated with conventional and novel protocols.
  
  
  METHODS
  The records of 138 elderly (≥65 yr) patients with MM were retrospectively evaluated.
  
  
  RESULTS
  The median overall survival(OS) of the patients was 46 months. The median progression-free survival (PFS) was 18 months. The OS and PFS of the patients treated with the conventional protocols did not differ significantly from those treated with the novel protocols. The statistical analysis of the quality of the response to the treatment with the conventional and novel therapies showed that complete remission (CR), combined with a very good partial response (VGPR), was significantly higher in the latter. However, the toxicities were higher in the novel treatment group.
  
  
  CONCLUSIONS
  The novel drug protocols significantly increased the quality of the responses of elderly patients with MM to therapy, but they did not increase the patients' tolerability.
authors.affiliation: Department of Hematology, Kocaeli University School of Medicine, Kocaeli, Turkey.
authors.forename: Pinar
authors.initials: P
authors.lastname: Tarkun
authors.forename: Figen
authors.initials: F
authors.lastname: Atalay
authors.forename: Elif Birtas
authors.initials: EB
authors.lastname: Atesoglu
authors.forename: Ozgur
authors.initials: O
authors.lastname: Mehtap
authors.forename: Melih
authors.initials: M
authors.lastname: Simsek
authors.forename: Esra
authors.initials: E
authors.lastname: Terzi
authors.forename: Ayfer
authors.initials: A
authors.lastname: Geduk
authors.forename: Fatih
authors.initials: F
authors.lastname: Balli
authors.forename: Adnan
authors.initials: A
authors.lastname: Batman
authors.forename: Canan
authors.initials: C
authors.lastname: Baydemir
authors.forename: Abdullah
authors.initials: A
authors.lastname: Hacihanefioglu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D000069286:Bortezomib / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011239:Prednisolone / Q000008:administration & dosage; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin; D011239:Prednisolone; D008558:Melphalan
keywords: drug toxicity; elderly; multiple myeloma; quality of response