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The characteristics of Korean elderly multiple myeloma patients aged 80 years or over
Sang Hwan Lee1, Hee-Jeong Cho2, Joon Ho Moon2
1Department of Hematology/Oncology, Daegu Fatima Hospital, Daegu, Korea.
Background/Aims:
Multiple myeloma (MM) predominantly affects elderly individuals, but studies on older patients with MM are limited. The clinical characteristics and survival outcomes of patients with MM aged 80 years or over were retrospectively analyzed.
Methods:
This retrospective multicenter study was conducted to investigate the clinical characteristics, treatment patterns, and survival outcomes of patients aged 80 years or over who were newly diagnosed with MM at five academic hospitals in Daegu, Korea, between 2010 and 2019.
Results:
A total of 127 patients with a median age of 83 years (range, 80-93 yr) were enrolled: 52 (40.9%) with Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, 84 (66.1%) with International Staging System (ISS) stage III disease, and 93 (73.2%) with a Charlson comorbidity index (CCI) > 4. Chemotherapy was administered to 86 patients (67.7%). The median overall survival was 9.3 months. Overall survival was significantly associated with ECOG PS > 2 (HR 2.26, 95% CI 1.43-3.59), ISS stage III (HR 1.99, 95% CI 1.18-3.34), and chemotherapy (HR 0.34, 95% CI 0.21-0.55). There was no statistically significant difference in event-free survival according to the type of anti-myeloma chemotherapy administered. The early mortality (EM) rate was 28.3%.
Conclusion:
Even in patients with MM aged 80 years or over, chemotherapy can result in better survival outcomes than supportive care. Patients aged ≥ 80 years should not be excluded from chemotherapy based on age alone. However, reducing EM in elderly patients with newly diagnosed MM remains challenging.
Insights
Chemotherapy improves survival in elderly patients (≥80 years) with multiple myeloma (MM), even with poor performance status or advanced disease. Age alone should not preclude treatment, though early mortality remains a challenge.
Area of Science:
- Hematology
- Geriatric Oncology
- Clinical Research
Background:
- Multiple myeloma (MM) primarily affects the elderly, yet data on very elderly patients (≥80 years) are scarce.
- Limited research exists on the specific clinical characteristics and outcomes of octogenarian MM patients.
Purpose of the Study:
- To analyze the clinical features, treatment approaches, and survival outcomes of newly diagnosed multiple myeloma patients aged 80 years and older.
- To identify factors influencing survival in this specific elderly demographic.
Main Methods:
- Retrospective multicenter study involving 127 patients aged 80+ diagnosed with MM between 2010-2019.
- Data collected on demographics, performance status (ECOG PS), disease stage (ISS), comorbidities (CCI), treatment, and survival outcomes.
- Statistical analysis to determine factors associated with overall survival (OS) and event-free survival (EFS).
Main Results:
- Median overall survival was 9.3 months.
- Poor ECOG PS (>2), advanced ISS stage (III), and lack of chemotherapy were associated with significantly worse survival.
- Chemotherapy administration was linked to improved overall survival (HR 0.34).
- Early mortality rate was 28.3%.
Conclusions:
- Chemotherapy offers survival benefits for multiple myeloma patients aged 80 years and over, compared to supportive care alone.
- Age should not be the sole criterion for excluding elderly patients from chemotherapy.
- Reducing early mortality in this population remains a critical challenge.
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