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Blood, 15 April 2008, Vol. 111, No. 8, pp. 4039-4047. Prepublished online as a Blood First Edition Paper on February 11, 2008; DOI 10.1182/blood-2007-03-081018. This Article Full Text Full Text (PDF) Supplemental Appendix and Tables All Versions of this Article: blood-2007-03-081018v1 111/8/4039    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ludwig, H. Articles by Crowley, J. Search for Related Content PubMed PubMed Citation Articles by Ludwig, H. Articles by Crowley, J. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival: an analysis of 10 549 patients from the International Myeloma Working Group Heinz Ludwig1, Brian G. M. Durie2, Vanessa Bolejack3, Ingemar Turesson4, Robert A. Kyle5, Joan Blade6, Rafael Fonseca7, Meletios Dimopoulos8, Kazuyuki Shimizu9, Jesus San Miguel10, Jan Westin11, Jean-Luc Harousseau12, Meral Beksac13, Mario Boccadoro14, Antonio Palumbo14, Bart Barlogie15, Chaim Shustik16, Michele Cavo17, Philip R. Greipp5, Douglas Joshua18, Michel Attal19, Pieter Sonneveld20, and John Crowley3 1 Department of Medicine, Wilhelminenspital, Vienna, Austria; 2 Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles, CA; 3 Cancer Research and Biostatistics, Seattle, WA; 4 Department of Hematology, University Hospital, Malmö, Sweden; 5 Division of Hematology, Mayo Clinic, Rochester, MN; 6 Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Institut d' Investigacious Biomediques August Pi i Sunyer, Barcelona, Spain; 7 Division of Hematology and Oncology, Mayo Clinic Comprehensive Cancer Center, Scottsdale, AZ; 8 Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece; 9 Department of Medicine, Nagoya City Midori General Hospital, Nagoya, Japan; 10 University Hospital of Salamanca, Salamanca, Spain; 11 Department of Hematology, University Hospital, Lund, Sweden; 12 Division of Hematology, Centre Hospitalier Universitaire Hotel-Dieu, Nantes, France; 13 Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey; 14 Divisione Universitaria di Ematologia, Ospedale Molinette, Torino, Italy; 15 Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR; 16 Department of Medicine, McGill University, Montreal, QC; 17 Institute of Hematology and Medical Oncology Seragnoli, University of Bologna, Bologna, Italy; 18 Institute of Haematology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; 19 Service d'Hématologie, Hôpital Purpan, Toulouse, France; and 20 Department of Hematology, Erasmus MC, Rotterdam, The Netherlands We analyzed the presenting features and survival in 1689 patients with multiple myeloma aged younger than 50 years compared with 8860 patients 50 years of age and older. Of the total 10 549 patients, 7765 received conventional therapy and 2784 received high-dose therapy. Young patients were more frequently male, had more favorable features such as low International Staging System (ISS) and Durie-Salmon stage as well as less frequently adverse prognostic factors including high C-reactive protein (CRP), low hemoglobin, increased serum creatinine, and poor performance status. Survival was significantly longer in young patients (median, 5.2 years vs 3.7 years; P < .001) both after conventional (median, 4.5 years vs 3.3 years; P < .001) or high-dose therapy (median, 7.5 years vs 5.7 years; P = .04). The 10-year survival rate was 19% after conventional therapy and 43% after high-dose therapy in young patients, and 8% and 29%, respectively, in older patients. Multivariate analysis revealed age as an independent risk factor during conventional therapy, but not after autologous transplantation. A total of 5 of the 10 independent risk factors identified for conventional therapy were also relevant for autologous transplantation. After adjusting for normal mortality, lower ISS stage and other favorable prognostic features seem to account for the significantly longer survival of young patients with multiple myeloma with age remaining a risk factor during conventional therapy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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