Professor Daegu Catholic University Hospital Daegu, Taegu-jikhalsi, Republic of Korea
Introduction: Multiple myeloma (MM) is primarily a disease of elderly patients. Although effective novel agents and supportive care have substantially improved outcomes, geriatric patients with MM have a higher risk of early mortality and lower survival rates. In this study, we retrospectively analyzed the clinical features and survival outcomes of MM patients aged ≥80 years.
Methods: MM patients aged ≥80 years from 2010 to 2019 at 5 hospitals in Daegu, Korea were eligible for inclusion were enrolled. The primary endpoints of this study were overall survival and prognostic factors for overall survival.
Results: A total of 127 patients, with a median age of 83 years (range, 80-93 years) were included in this analysis. Of these, 52 patients (40.9%) had a poor performance status (ECOG 3-4), 84 (66.1%) had an International Staging System (ISS) stage III disease, and 69 (54.3%) had a Charlson comorbidity index score of 2 or more. Chemotherapy was given to 86 patients (67.7%). The median overall survival of all patients was 13.8 months. Thirty-four patients (26.8%) died within 3 months of MM diagnosis. In the univariate analysis, prognostic factors for overall survival were age (80-83 vs. >83, p=0.017), ECOG performance status (0-2 vs. 3,4, p< 0.001), ISS stage (I, II vs. III, p=0.005), hypercalcemia (p=0.007), thrombocytopenia (p=0.007) and treatment (chemotherapy vs. best supportive care, p< 0.001). In multivariate analyses, overall survival was affected by ECOG performance status, ISS stage, and chemotherapy treatment.
Conclusions: Some elderly MM patients aged ≥80 years exhibit very poor prognosis, highlighting the need to effectively distinguish such patients and develop appropriate best supportive care for them.
