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Multiple myeloma in elderly patients: presenting features and outcome
P Rodon1, C Linassier, J B Gauvain
1Department of Internal Medicine and Haematology, Centre Hospitalier Général, Blois, France. rodon.philippe@wanadoo.fr
European Journal of Haematology
|February 13, 2001
Summary
Elderly patients with multiple myeloma (MM) aged 75+ can tolerate conventional chemotherapy, showing a 62% response rate. Age over 85, poor performance status, and high creatinine are key predictors of shorter survival.
Area of Science:
- Hematology
- Geriatric Medicine
- Oncology
Background:
- Multiple myeloma (MM) is a hematologic malignancy primarily affecting older adults.
- Limited data exists on the characteristics and outcomes of MM in patients aged 75 years and older.
Purpose of the Study:
- To evaluate the clinical presentation, treatment response, toxicity, survival, and prognostic factors in elderly patients (≥75 years) diagnosed with multiple myeloma.
Main Methods:
- Retrospective analysis of 130 unselected patients with MM aged 75 years or more at diagnosis.
- Patients received conventional chemotherapy; response rates, toxicity, and survival were assessed.
- Prognostic factors for survival were analyzed using univariate and Cox multivariate regression.
Main Results:
- Presenting features were similar to younger patients, with a higher infection rate and significant comorbidity.
- Sixty-two percent of patients receiving chemotherapy responded, with mild treatment toxicity.
- Median survival was 22 months. Age ≥85, performance status ≥2, and creatinine ≥120 µmol/L were independent predictors of short survival.
Conclusions:
- Age alone should not preclude active treatment for symptomatic multiple myeloma in elderly patients.
- Further prospective trials are warranted to assess treatment efficacy and quality of life in this population.