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Multiple myeloma in elderly patients: presenting features and outcome
Author(s) -
Rodon Philippe,
Linassier Claude,
Gauvain JeanBernard,
Benboubker Lotfi,
Goupille Philippe,
Maigre Michel,
Luthier François,
Dugay Jacqueline,
Lucas Virginie,
Colombat Philippe
Publication year - 2001
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1034/j.1600-0609.2001.00301.x
Subject(s) - medicine , creatinine , gastroenterology , univariate analysis , chemotherapy , population , multiple myeloma , performance status , comorbidity , multivariate analysis , renal function , surgery , environmental health
Few studies have been performed regarding multiple myeloma (MM) in elderly patients. We report a retrospective series of 130 unselected patients with MM aged 75 yr or more at diagnosis. Presenting features were identical to those reported in younger patients, except for a higher rate of infection. Heavy comorbidity was characteristic of unselected geriatric patients. Ninety‐four patients received conventional chemotherapy. The response rate was 62%. Treatment toxicity was mild. Median survival was 22 months. Durie–Salmon (DS) clinical stages II and III MM were severe and often led to death, while significantly more patients with DS stage I MM died from unrelated causes ( p <0.0001). Univariate analysis showed that age 85 yr, performance status 2, creatinine level 120 µmol/l, beta 2 microglobulin level >4 mg/l, C‐reactive protein level >6 mg/l, platelet count <100×10 9 /l, presence of infection and lack of response to chemotherapy were adverse prognostic factors for survival. In Cox multivariate regression analysis, age 85 yr ( p <0.0001), performance status 2 ( p <0.0001) and creatinine level 120 µmol/l ( p <0.0001) were independent factors in predicting short survival. This study provides evidence that in patients with symptomatic MM age should not be considered as a major obstacle to active treatment. Prospective clinical trials are needed in this population of patients and should include an assessment of quality of life.