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
Marie-Lorraine Chretien,
Benjamin Hebraud,
Valérie Cances-Lauwers,
Cyrille Hulin,
Gerald Marit,
Xavier Leleu,
Lionel Karlin,
Murielle Roussel,
Anne-Marie Stoppa,
Francois Guilhot,
Thierry Lamy,
Laurent Garderet,
Brigitte Pegourie,
Mamoun Dib,
Catherine Sebban,
Pascal Lenain,
Sabine Brechignac,
Bruno Royer,
Marc Wetterwald,
Laurence Legros,
Frédérique Orsini-Piocelle,
Laurent Voillat,
Xavier Delbrel,
Denis Caillot,
Margaret Macro,
Thierry Facon,
Michel Attal,
Philippe Moreau,
Hervé Avet-Loiseau,
Jill Corre
Affiliations
Marie-Lorraine Chretien
Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse;Department of Hematology, University Hospital, Dijon
Benjamin Hebraud
Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse
Valérie Cances-Lauwers
Service d’Epidémiologie, CHU Toulouse
Cyrille Hulin
Department of Hematology, University Hospital, Nancy
Gerald Marit
Department of Hematology, University Hospital, Bordeaux
Xavier Leleu
Department of Hematology, University Hospital, Lille;
Lionel Karlin
Department of Hematology, University Hospital, Lyon
Murielle Roussel
Department of Hematology, University Hospital, Toulouse
Anne-Marie Stoppa
Department of Hematology, Institut Paoli Calmette, Marseille
Francois Guilhot
CIC Inserm 0802, Centre Hospitalier Universitaire, Poitiers
Thierry Lamy
Department of Hematology, University Hospital, Rennes
Laurent Garderet
Department of Hematology, University Hospital, St-Antoine, Paris
Brigitte Pegourie
Department of Hematology, University Hospital, Grenoble
Mamoun Dib
Department of Hematology, University Hospital, Angers
Catherine Sebban
Department of Hematology, Centre Léon Bérard, Lyon
Pascal Lenain
Department of Hematology, Centre Becquerel, Rouen
Sabine Brechignac
Department of Hematology, University Hospital, Bobigny
Bruno Royer
Department of Hematology, University Hospital, Amiens
Marc Wetterwald
Department of Hematology, Departmental Hospital, Dunkerque
Laurence Legros
Department of Hematology, University Hospital, Nice
Frédérique Orsini-Piocelle
Department of Hematology, Departmental Hospital, Annecy
Laurent Voillat
Department of Hematology, Departmental Hospital, Chalon
Xavier Delbrel
Department of Hematology, Departmental Hospital, Pau
Denis Caillot
Department of Hematology, University Hospital, Dijon
Margaret Macro
Department of Hematology, University Hospital, Caen
Thierry Facon
Department of Hematology, University Hospital, Lille;
Michel Attal
Department of Hematology, University Hospital, Toulouse
Philippe Moreau
Department of Hematology, University Hospital, Nantes, France
Hervé Avet-Loiseau
Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse
Jill Corre
Unité de Génomique du Myélome, University Hospital; CRCT, INSERM U 1037; Université Paul Sabatier, Toulouse
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.
