Myeloma in the Octogenarians: Disease Characteristics and Clinical Outcomes in the Era of Modern Anti-Myeloma Therapy
| Autor: | Evangelos Kostis, Zafiris Kartasis, Despoina Kalapanida, Dimitra Gika, Sofoklis Kontogiannis, Athanasios Zomas, Maria Gavriatopoulou, Evangelos Terpos, Charis Matsouka, Maria Roussou, Meletios A. Dimopoulos, Evangelos Eleutherakis-Papaiakovou, Efstathios Kastritis, Despoina Mparmparoussi, Kostas Konstantopoulos |
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| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Blood. 124:4738-4738 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood.v124.21.4738.4738 |
| Popis: | Multiple Myeloma (MM) is a disease of the elderly and due to the aging population an increasing number of patients are diagnosed at the age ≥80 year. The management of these octogenarians is challenging due to their frailty as a result of co-morbidities and of age-related deterioration of organ function (lung, renal, cardiac). Indeed, age ≥80 year alone is a sufficient parameter to define frailty, according to IMWG recommendations. Thus, most octogenarians are not eligible and are not recruited in clinical trials. The aim of our study was to analyze the disease characteristics and treatment outcomes of patients ≥80 years of age. All patients with symptomatic MM since 1994, who received at least one dose of any therapy and were followed in our center (University of Athens, Greece) were included in the analysis. Among 610 consecutive patients, 84 (14%) were ≥80 years of age. During these 20 years, there was a steady increase in the proportion of patients ≥80 years who were treated for MM (10% during the 1994-1999 period, 12% during 2000-2005, 14% during 2006-2010 and 16% after 2011). Compared to patients ≤65 years and those 66-79 years, octogenarians had more often moderate or severe renal impairment (p Patients ≤65 years received more often bortezomib-based regimens upfront (61% vs 15% vs 11% respectively, p The median overall survival (OS) was 66% at 5 years for patients ≤65 years, 46 months for those 66-79 years and only 19.5 months for octogenarians (p In conclusion, myeloma patients ≥80 years present with poor prognostic features, which are probably related to non-MM related conditions, since high risk MM features (such as adverse cytogenetics) are less common. The management of octogenarians should take into account not only myeloma but also their general condition. A comprehensive geriatric assessment should routinely be performed in these patients, in order to identify those most vulnerable and those most likely to tolerate and benefit from novel therapies. Disclosures No relevant conflicts of interest to declare. |
| Databáze: | OpenAIRE |
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