Long-term survival in multiple myeloma: a single-center experience

In patients with multiple myeloma the median overall survival is now approaching 5 years, following the introduction of autologous stem cell transplantation and targeted therapies. However, patients receiving conventional chemotherapy who have survived 10 years or longer have been repeatedly reported in the literature. From 723 patients with multiple myeloma seen in our department from January 1981 to June 2007, we selected 21 long-term (> or =10 years) survivors (2.9%) who had been treated with conventional chemotherapy. Potentially favourable prognostic factors, common to most patients, were: age < or =65 years; response to first-line chemotherapy; absence of Bence-Jones proteinuria; prolonged duration of response or stable disease irrespective of the primary regimen; maintenance therapy with interferon-alpha. The use of prognostic factors to identify a subset of low-risk patients could be of assistance in the selection of targeted treatments and the elucidation of poorly known features of myeloma biology.