EPIDEMIOLOGICAL LANDSCAPE OF YOUNG MULTIPLE MYELOMA PATIENTS DIAGNOSED EARLIER THAN 40 YEARS: THE FRENCH EXPERIENCE.
Fiche publication
Date publication
septembre 2021
Journal
Blood
Auteurs
Membres identifiés du Cancéropôle Est :
Dr CAILLOT Denis
Tous les auteurs :
Caulier A, Roussel M, Morel P, Lombion N, Branco B, Galtier J, Hulin C, Perrot A, Richez V, Michaud-Robert AV, Touzeau C, Doyen C, Mariette C, Caillot D, Harel S, Lenain P, Ivanoff S, Fontan J, Stoppa AM, Manier S, Garderet L, Leleu X, Marolleau JP, Arnulf B, Avet-Loiseau H, Royer B
Lien Pubmed
Résumé
Multiple Myeloma (MM) is rare in young patients - especially before 40 years at diagnosis, representing less than 2% of all patients with MM. Little is known about the disease characteristics and prognosis of these patients. In this study we examined 214 patients diagnosed with MM ≤ 40 years old over 15 years, in the era of modern treatments. Among them, 189 patients had symptomatic MM. Disease characteristics were similar to older patients: 35% had anemia, 17% had renal impairment, and 13% hypercalcemia. The staging was ISS-1 in 52.4%, ISS-2 in 27.5% and ISS-3 in 20.1%. Overall, 18% of patients had high risk cytogenetics (del 17p and/or t(4;14)). Ninety percent of patients received intensive chemotherapy followed by autologous stem cell transplant, and 25% of patients had allogeneic stem cell transplantation predominantly at time of relapse. The median follow-up was 76 months, the estimated median overall survival was 14.5 years and the median PFS was 41 months. In multivariate analysis, bone lesions (HR=3.95; p=0.01), high ISS score (HR=2.14; p=0.03) and high-risk cytogenetics (HR=4.54; p<0.0001) were significant risk factors for poor outcomes. Among predefined time-dependent covariables, onset of progression (HR=13.2; p<0.0001) significantly shortened OS. At 5 years, Relative Survival compared to same age and sex matched individuals was 83.5%, and estimated Standardized Mortality Ratio was 69.9 (95%CI 52.7-91.1), confirming that MM dramatically shortens the survival of young patients despite an extended survival after diagnosis.
Référence
Blood. 2021 Sep 3;: