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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 (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 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 HighWire 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 21, 2007 Accepted January 14, 2008 Myeloma in patients under age 50 presents with more favorable features and shows better survival: an analysis of 10,549 patients from the International Myeloma Working Group Heinz Ludwig*, Brian G.M. Durie, Vanessa Bolejack, Ingemar Turesson, Robert A. Kyle, Joan Blade, Rafael Fonseca, Meletios Dimopoulos, Kazuyuki Shimizu, Jesus San Miguel, Jan Westin, Jean-Luc Harousseau, Meral Beksac, Mario Boccadoro, Antonio Palumbo, Bart Barlogie, Chaim Shustik, Michele Cavo, Douglas Joshua, Michel Attal, Pieter Sonneveld, and John Crowley Department of Medicine I, Wilhelminenspital, Vienna, Austria International Myeloma Foundation, Cedars Sinai Comprehensive Cancer Center, Los Angeles, CA, United States Department of Biostatistical Analysis, Cancer Research and Biostatistics, Seattle, WA, United States Department of Hematology, University Hospital, Malmo, Sweden Division of Hematology, Mayo Clinic, Rochester, MN, United States Hematology Department, Hospital Clinic IDIBAPS, Barcelona, Spain Division of Hematology and Oncology, Mayo Clinic Comprehensive Cancer Center, Scottsdale, AZ, United States Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece Department of Medicine, Nagoya City Midori General Hospital, Nagoya, Japan Department of Hematology, University Hospital of Salamanca, Salamanca, Spain Department of Hematology, University Hospital Lund, Lund, Sweden Division of Hematology, Centre Hospitalier Universitaire Hotel-Dieu, Nantes, France Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey Divisione Universitaria di Ematologia, Ospedale Molinette, Torino, Italy Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, United States Department of Medicine, McGill University, Montreal, Canada Institute of Hematology and Medical Oncology 'Seragnoli', University of Bologna, Bologna, Italy Institute of Haematology, Royal Prince Alfred Hospital, Sydney, Australia Service d'Hematologie, Hopital Purpan, Toulouse, France Department of Hematology, Erasmus MC, Rotterdam, Netherlands * Corresponding author; email: heinz.ludwig{at}wienkav.at. We analyzed the presenting features and survival in 1,689 patients with multiple myeloma aged <50 years compared to 8,860 patients 50 years of age. 7,765 of the total 10,549 patients received conventional and 2,784 high-dose therapy. Young patients were more frequently male, had more favorable features such as low ISS and D/S stage as well as less frequently adverse prognostic factors including high CRP, low hemoglobin, increased serum creatinine and poor performance status. Survival was significantly longer in young patients (median 5.2 years versus 3.7 years; P<.001) both after conventional (median: 4.5 years versus 3.3 years; P<.001) or high-dose therapy (median: 7.5 years versus 5.7 years; P=.04). Ten-year survival rate was 19% after conventional and 43% after high-dose therapy in young, 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. Five 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? This article has been cited by other articles: H. Ludwig, R. Hajek, E. Tothova, J. Drach, Z. Adam, B. Labar, M. Egyed, I. Spicka, H. Gisslinger, R. Greil, et al. Thalidomide-dexamethasone compared with melphalan-prednisolone in elderly patients with multiple myeloma Blood, April 9, 2009; 113(15): 3435 - 3442. [Abstract] [Full Text] [PDF] M. Rotta, B. E. Storer, F. Sahebi, J. A. Shizuru, B. Bruno, T. Lange, E. D. Agura, P. A. McSweeney, M. A. Pulsipher, P. Hari, et al. Long-term outcome of patients with multiple myeloma after autologous hematopoietic cell transplantation and nonmyeloablative allografting Blood, April 2, 2009; 113(14): 3383 - 3391. [Abstract] [Full Text] [PDF] B. G.M. Durie Myeloma Therapy: 25 Years Forward--Immune Modulation Then and Now J. Clin. Oncol., October 10, 2008; 26(29): 4698 - 4700. [Full Text] [PDF] B. G.M. Durie Treatment of Myeloma -- Are We Making Progress? N. Engl. J. Med., August 28, 2008; 359(9): 964 - 966. [Full Text] [PDF]

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