Age is a prognostic factor even among patients with multiple myeloma younger than 66 years treated with high-dose melphalan: the IFM experience on 2316 patients

被引：34

作者：

Chretien, Marie-Lorraine ^{[1
,2
,3
,4
]}

Hebraud, Benjamin ^{[1
,2
,3
]}

Cances-Lauwers, Valerie ^{[5
]}

Hulin, Cyrille ^{[6
]}

Marit, Gerald ^{[7
]}

Leleu, Xavier ^{[8
]}

Karlin, Lionel ^{[9
]}

Roussel, Murielle ^{[10
]}

Stoppa, Anne-Marie ^{[11
]}

Guilhot, Francois ^{[12
]}

Lamy, Thierry ^{[13
]}

Garderet, Laurent ^{[14
]}

Pegourie, Brigitte ^{[15
]}

Dib, Mamoun ^{[16
]}

Sebban, Catherine ^{[17
]}

Lenain, Pascal ^{[18
]}

Brechignac, Sabine ^{[19
]}

Royer, Bruno ^{[20
]}

Wetterwald, Marc ^{[21
]}

Legros, Laurence ^{[22
]}

Orsini-Piocelle, Frederique ^{[23
]}

Voillat, Laurent ^{[24
]}

Delbrel, Xavier ^{[25
]}

Caillot, Denis ^{[4
]}

Macro, Margaret ^{[26
]}

Facon, Thierry ^{[8
]}

Attal, Michel ^{[10
]}

Moreau, Philippe ^{[27
]}

Avet-Loiseau, Herve ^{[1
,2
,3
]}

Corre, Jill ^{[1
,2
,3
]}

机构：

[1] Univ Hosp, Unite Genom Myelome, Toulouse, France

[2] INSERM U1037, CRCT, Toulouse, France

[3] Univ Toulouse 3, F-31062 Toulouse, France

[4] Univ Hosp, Dept Hematol, Dijon, France

[5] CHU Toulouse, Serv Epidemiol, Toulouse, France

[6] Univ Hosp, Dept Hematol, Nancy, France

[7] Univ Hosp, Dept Hematol, Bordeaux, France

[8] Univ Hosp, Dept Hematol, Lille, France

[9] Univ Hosp, Dept Hematol, Lyon, France

[10] Univ Hosp, Dept Hematol, Toulouse, France

[11] Inst Paoli Calmette, Dept Hematol, Marseille, France

[12] Ctr Hosp Univ, CIC Inserm 0802, Poitiers, France

[13] Univ Hosp, Dept Hematol, Rennes, France

[14] Univ Hosp, Dept Hematol, Paris, France

[15] Univ Hosp, Dept Hematol, Grenoble, France

[16] Univ Hosp, Dept Hematol, Angers, France

[17] Ctr Leon Berard, Dept Hematol, F-69373 Lyon, France

[18] Ctr Becquerel, Dept Hematol, Rouen, France

[19] Univ Hosp, Dept Hematol, Bobigny, France

[20] Univ Hosp, Dept Hematol, Amiens, France

[21] Dept Hosp, Dept Hematol, Dunkerque, France

[22] Univ Hosp, Dept Hematol, Nice, France

[23] Dept Hosp, Dept Hematol, Annecy, France

[24] Dept Hosp, Dept Hematol, Chalon Sur Saone, France

[25] Dept Hosp, Dept Hematol, Pau, France

[26] Univ Hosp, Dept Hematol, Caen, France

[27] Univ Hosp, Dept Hematol, Nantes, France

来源：

HAEMATOLOGICA | 2014年 / 99卷 / 07期

关键词：

INTERGROUPE FRANCOPHONE; SURVIVAL; ABNORMALITIES; FEATURES;

D O I：

10.3324/haematol.2013.098608

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Age is a strong prognostic factor in multiple myeloma. The overall survival is shorter in patients older than 66 years, and even shorter in those older than 75 years. Whether age is also a prognostic parameter in patients younger than 66 years treated homogeneously with intensive approaches is unknown. To address this issue, we retrospectively analyzed a series of 2316 patients treated homogeneously with 3-4 cycles of induction chemotherapy followed by a high-dose melphalan course, without any consolidation or maintenance. We show that patients older than 60 years have a statistically significant shorter overall survival. The analysis of prognostic parameters did not show a higher incidence of high-risk cytogenetics, but a higher incidence of International Staging System (ISS) stages 2 and 3, mainly due to higher beta 2-microglobulin levels. This study is the first to demonstrate the impact of age in the outcome of 'young' patients with multiple myeloma, and suggests that this parameter should be included in the stratification factors for future prospective clinical trials.

引用

页码：1236 / 1238

页数：3

共 8 条

[1] Genetic abnormalities and survival in multiple myeloma: the experience of the Intergroupe Francophone du Myelome [J].

Avet-Loiseau, Herve ;

Attal, Michel ;

Moreau, Philippe ;

Charbonnel, Catherine ;

Garban, Frederic ;

Hulin, Cyrille ;

Leyvraz, Serge ;

Michallet, Mauricette ;

Yakoub-Agha, Ibrahim ;

Garderet, Laurent ;

Marit, Gerald ;

Michaux, Lucienne ;

Voillat, Laurent ;

Renaud, Marc ;

Grosbois, Bernard ;

Guillerm, Gaelle ;

Benboubker, Lotfi ;

Monconduit, Mathieu ;

Thieblemont, Catherine ;

Casassus, Philippe ;

Caillot, Denis ;

Stoppa, Anne-Marie ;

Sotto, Jean-Jacques ;

Wetterwald, Marc ;

Dumontet, Charles ;

Fuzibet, Jean-Gabriel ;

Azais, Isabelle ;

Dorvaux, Veronique ;

Zandecki, Marc ;

Bataille, Regis ;

Minvielle, Stephane ;

Harousseau, Jean-Luc ;

Facon, Thierry ;

Mathiot, Claire .

BLOOD, 2007, 109 (08) :3489-3495

[2] Chromosomal Abnormalities Are Major Prognostic Factors in Elderly Patients With Multiple Myeloma: The Intergroupe Francophone du Myelome Experience [J].

Avet-Loiseau, Herve ;

Hulin, Cyrille ;

Campion, Loic ;

Rodon, Philippe ;

Marit, Gerald ;

Attal, Michel ;

Royer, Bruno ;

Dib, Mamoun ;

Voillat, Laurent ;

Bouscary, Didier ;

Caillot, Denis ;

Wetterwald, Marc ;

Pegourie, Brigitte ;

Lepeu, Gerard ;

Corront, Bernadette ;

Karlin, Lionel ;

Stoppa, Anne-Marie ;

Fuzibet, Jean-Gabriel ;

Delbrel, Xavier ;

Guilhot, Francois ;

Kolb, Brigitte ;

Decaux, Olivier ;

Lamy, Thierry ;

Garderet, Laurent ;

Allangba, Olivier ;

Lifermann, Francois ;

Anglaret, Bruno ;

Moreau, Philippe ;

Harousseau, Jean-Luc ;

Facon, Thierry .

JOURNAL OF CLINICAL ONCOLOGY, 2013, 31 (22) :2806-+

[3] Presenting features and prognosis in 72 patients with multiple myeloma who were younger than 40 years [J].

Blade, J ;

Kyle, RA ;

Greipp, PR .

BRITISH JOURNAL OF HAEMATOLOGY, 1996, 93 (02) :345-351

[4] Age and organ damage correlate with poor survival in myeloma patients: meta-analysis of 1435 individual patient data from 4 randomized trials [J].

Bringhen, Sara ;

Victoria Mateos, Maria ;

Zweegman, Sonja ;

Larocca, Alessandra ;

Falcone, Antonietta Pia ;

Oriol, Albert ;

Rossi, Davide ;

Cavalli, Maide ;

Wijermans, Pierre ;

Ria, Roberto ;

Offidani, Massimo ;

Jose Lahuerta, Juan ;

Liberati, Anna Marina ;

Mina, Roberto ;

Callea, Vincenzo ;

Schaafsma, Martijn ;

Cerrato, Chiara ;

Marasca, Roberto ;

Franceschini, Luca ;

Evangelista, Andrea ;

Teruel, Ana-Isabel ;

van der Holt, Bronno ;

Montefusco, Vittorio ;

Ciccone, Giovannino ;

Boccadoro, Mario ;

San Miguel, Jesus ;

Sonneveld, Pieter ;

Palumbo, Antonio .

HAEMATOLOGICA, 2013, 98 (06) :980-987

[5] International staging system for multiple myeloma [J].

Greipp, PR ;

San Miguel, J ;

Durie, BGM ;

Crowley, JJ ;

Barlogie, B ;

Bladé, J ;

Boccadoro, M ;

Child, JA ;

Harousseau, JL ;

Kyle, RA ;

Lahuerta, JJ ;

Ludwig, H ;

Morgan, G ;

Powles, R ;

Shimizu, K ;

Shustik, C ;

Sonneveld, P ;

Tosi, P ;

Turesson, I ;

Westin, J .

JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (15) :3412-3420

[6] Impact of age on survival after intensive therapy for multiple myeloma:: a population-based study by the Nordic Myeloma Study Group [J].

Lenhoff, S ;

Hjorth, M ;

Westin, J ;

Brinch, L ;

Bäckström, B ;

Carlson, K ;

Christiansen, I ;

Dahl, IM ;

Gimsing, P ;

Hammerström, J ;

Johnsen, HE ;

Juliusson, G ;

Linder, O ;

Mellqvist, UH ;

Nesthus, I ;

Nielsen, JL ;

Tangen, JM ;

Turesson, I .

BRITISH JOURNAL OF HAEMATOLOGY, 2006, 133 (04) :389-396

[7] 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 [J].

Ludwig, Heinz ;

Durie, Brian G. M. ;

Bolejack, Vanessa ;

Turesson, Ingemar ;

Kyle, Robert A. ;

Blade, Joan ;

Fonseca, Rafael ;

Dimopouios, Meletios ;

Shimizu, Kazuyuki ;

Miguel, Jesus San ;

Westin, Jan ;

Harousseau, Jean-Luc ;

Beksac, Meral ;

Boccadoro, Mario ;

Palumbo, Antonio ;

Barlogie, Bart ;

Shustik, Chaim ;

Cavo, Michele ;

Greipp, Philip R. ;

Joshua, Douglas ;

Attal, Michel ;

Sonneveld, Pieter ;

Crowley, John .

BLOOD, 2008, 111 (08) :4039-4047

[8] Bortezomib plus dexamethasone versus reduced-dose bortezomib, thalidomide plus dexamethasone as induction treatment before autologous stem cell transplantation in newly diagnosed multiple myeloma [J].

Moreau, Philippe ;

Avet-Loiseau, Herve ;

Facon, Thierry ;

Attal, Michel ;

Tiab, Mourad ;

Hulin, Cyrille ;

Doyen, Chantal ;

Garderet, Laurent ;

Randriamalala, Edouard ;

Araujo, Carla ;

Lepeu, Gerard ;

Marit, Gerald ;

Caillot, Denis ;

Escoffre, Martine ;

Lioure, Bruno ;

Benboubker, Lotfi ;

Pegourie, Brigitte ;

Kolb, Brigitte ;

Stoppa, Anne Marie ;

Fuzibet, Jean-Gabriel ;

Decaux, Olivier ;

Dib, Mamoun ;

Berthou, Christian ;

Chaleteix, Carine ;

Sebban, Catherine ;

Traulle, Catherine ;

Fontan, Jean ;

Wetterwald, Marc ;

Lenain, Pascal ;

Mathiot, Claire ;

Harousseau, Jean-Luc .

BLOOD, 2011, 118 (22) :5752-5758

← 1 →