Yanamandra Uday, Saini Neha, Chauhan Pooja, Sharma Tanya, Khadwal Alka, Prakash Gaurav, Varma Neelam, Lad Deepesh, Varma Subhash, Malhotra Pankaj
1 Clinical Hematology Division , Department of Internal Medicine, PGIMER, Chandigarh, India .
2 Department of Internal Medicine, Government Medical College and Hospital (GMCH) , Chandigarh, Punjab, India .
J Adolesc Young Adult Oncol. 2018 Feb;7(1):120-124. doi: 10.1089/jayao.2017.0034. Epub 2017 Aug 22.
Multiple myeloma (MM) is considered as a disease of the old with the reported median age of 60-70 years. The disease occurred a decade earlier in the Indian subcontinent. The literature on MM in adolescents and young adult (AYA) is limited. We studied the disease characteristics and outcomes of the AYA-MM in the real-world setting.
It is a retrospective single-center study conducted at a tertiary care center from North India. Records of all consecutive patients with AYA-MM (15-39 years of age) who were managed from January 1, 2010, to December 30, 2015, were reviewed. Survival was assessed from the date of start of treatment to the last follow-up date or death due to any cause.
A total of 415 patients managed for MM were included in the study. The frequency of the AYA-MM was 9.6% (40/415) of whom 5 patients were younger than 30 years. There was male preponderance with a median age of the patients being 38 years. The main presenting features were bone pain (55%), fatigue (45%), extramedullary plasmacytomas (20%), and infections (12%) and referral from the peripheral hospital as renal dysfunction (58%). On the evaluation of patients, hypercalcemia, renal impairment, anemia, and lytic lesions were seen in 24.32%, 30%, 52.5%, and 59.25% of patients, respectively. The majority had the high-risk disease (International Staging System [ISS]-III: 75%). Only 22.5% patients were transplanted. The 3-year median overall survival of the study population was 80.21%.
AYA-MM patients have a higher prevalence of extramedullary disease and high-risk disease.
多发性骨髓瘤（MM）被认为是一种老年疾病，报告的中位年龄为60 - 70岁。该疾病在印度次大陆早十年出现。关于青少年和青年成人（AYA）多发性骨髓瘤的文献有限。我们在真实世界环境中研究了AYA-MM的疾病特征和结局。
这是一项在印度北部一家三级医疗中心进行的回顾性单中心研究。回顾了2010年1月1日至2015年12月30日期间所有连续治疗的AYA-MM（15 - 39岁）患者的记录。从治疗开始日期至最后随访日期或因任何原因死亡评估生存情况。
本研究共纳入415例接受MM治疗的患者。AYA-MM的发生率为9.6%（40/415），其中5例患者年龄小于30岁。男性占优势，患者中位年龄为38岁。主要表现特征为骨痛（55%）、疲劳（45%）、髓外浆细胞瘤（20%）、感染（12%）以及因肾功能不全从外周医院转诊（58%）。在患者评估中，高钙血症、肾功能损害、贫血和溶骨性病变分别见于24.32%、30%、52.5%和59.25%的患者。大多数患者患有高危疾病（国际分期系统[ISS]-III：75%）。仅22.5%的患者接受了移植。研究人群的3年中位总生存率为80.21%。
AYA-MM患者髓外疾病和高危疾病的患病率较高。
