Department of Hematology, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey.
Department of Internal Diseases, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey.
Curr Oncol. 2023 Jun 9;30(6):5615-5630. doi: 10.3390/curroncol30060423.
The study aims to investigate second primary malignancy (SPM) development and frailty in Turkish geriatric patients with multiple myeloma (MM) and to assess the relationship between overall survival (OS) and various characteristics including SPM and frailty. Seventy-two patients diagnosed with and treated for MM were enrolled in the study. Frailty was determined by the IMWG Frailty Score. Fifty-three participants (73.6%) were found to have clinically-relevant frailty. Seven patients (9.7%) had SPM. Median follow-up was 36.5 (22-48.5) months, and 17 patients died during the follow-up period. Overall (OS) was 49.40 (45.01-53.80) months. Shorter OS was found in patients with SPM (35.29 (19.66-50.91) months) compared to those without (51.05 (46.7-55.4) months) (Kaplan-Meier; = 0.018). The multivariate cox proportional hazards model revealed that patients with SPM had 4.420-fold higher risk of death than those without (HR: 4.420, 95% CI: 1.371-14.246, = 0.013). Higher ALT levels were also independently associated with mortality ( = 0.038). The prevalence of SPM and frailty was high in elderly patients with MM in our study. The development of SPM independently reduces survival in MM; however, frailty was not found to be independently associated with survival. Our results suggest the importance of individualized approaches in the management of patients with MM, particularly with regard to SPM development.
本研究旨在探讨土耳其老年多发性骨髓瘤（MM）患者第二原发恶性肿瘤（SPM）的发生和虚弱情况，并评估总生存（OS）与包括 SPM 和虚弱在内的各种特征之间的关系。本研究纳入了 72 例经诊断和治疗的 MM 患者。采用 IMWG 虚弱评分来确定虚弱情况。53 名参与者（73.6%）被发现存在临床相关的虚弱。7 名患者（9.7%）发生 SPM。中位随访时间为 36.5（22-48.5）个月，随访期间有 17 名患者死亡。总（OS）为 49.40（45.01-53.80）个月。与无 SPM 患者相比，有 SPM 患者的 OS 更短（35.29（19.66-50.91）个月）（Kaplan-Meier 检验； = 0.018）。多变量 Cox 比例风险模型显示，有 SPM 的患者死亡风险比无 SPM 的患者高 4.420 倍（HR：4.420，95%CI：1.371-14.246， = 0.013）。较高的 ALT 水平也与死亡率独立相关（ = 0.038）。在本研究中，老年 MM 患者 SPM 和虚弱的发生率较高。SPM 的发生独立降低 MM 患者的生存，但虚弱与生存无独立相关性。我们的研究结果表明，在 MM 患者的管理中，个体化方法非常重要，特别是在 SPM 发生方面。
