Shin Junghoon, Koh Youngil, Youk Jeonghwan, Kim Miso, Kim Byung Soo, Choi Chul Won, Sung Hwa Jung, Park Yong, Yoon Sung-Soo, Kim Inho
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2017 Jul;32(4):722-730. doi: 10.3904/kjim.2016.256. Epub 2017 Jun 26.
BACKGROUND/AIMS: Although multiple myeloma (MM) is typically a disease of the elderly, a certain subset of extremely young patients exists. It is necessary to establish clinicopathological characteristics for this population.
We reviewed the medical records of MM patients whose age was 40 years or younger at diagnosis.
A total of 32 patients were analyzed (male to female ratio 19:13, median age 37 years). According to International Staging System, 29%, 48%, and 16% were in stage I, II, and III, respectively. Light chain myeloma accounted for 30%. Clinically significant anemia, hypercalcemia, azotemia, and hypoalbuminemia were present in 29%, 28%, 13%, and 28%, respectively. Three or more lytic bone lesions were detected in 45% of the patients, whereas 13% had no lytic bone lesions. Regarding treatment, 79% of patients received autologous hematopoietic stem cell transplantation. After a median follow-up duration of 64 months, the 1-, 3-, and 5-year overall survival (OS) rates were 84%, 62%, and 54%, respectively. The median OS was 61 months for the entire cohort.
In our study, MM patients aged 40 years or younger at diagnosis showed no superior survival compared to those of the moderately elderly patients based on historical data.
背景/目的:虽然多发性骨髓瘤(MM)通常是一种老年疾病,但存在一小部分极其年轻的患者。有必要确定这一人群的临床病理特征。
我们回顾了诊断时年龄在40岁及以下的MM患者的病历。
共分析了32例患者(男女比例为19:13,中位年龄37岁)。根据国际分期系统,分别有29%、48%和16%的患者处于I期、II期和III期。轻链骨髓瘤占30%。临床上显著的贫血、高钙血症、氮质血症和低白蛋白血症分别占29%、28%、13%和28%。45%的患者检测到三个或更多溶骨性骨病变,而13%的患者没有溶骨性骨病变。关于治疗,79%的患者接受了自体造血干细胞移植。中位随访时间为64个月后,1年、3年和5年总生存率(OS)分别为84%、62%和54%。整个队列的中位OS为61个月。
在我们的研究中,根据历史数据,诊断时年龄在40岁及以下的MM患者与中度老年患者相比,生存率并无优势。