Haematologica (Jul 2014)

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

DOI
https://doi.org/10.3324/haematol.2013.098608
Journal volume & issue
Vol. 99, no. 7

Abstract

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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.