Lee Sang Hwan, Cho Hee-Jeong, Moon Joon Ho, Jung Ji Yoon, Kim Min Kyoung, Heo Mi Hwa, Do Young Rok, Hwang Yunhwi, Bae Sung Hwa
Department of Hematology/Oncology, Daegu Fatima Hospital, Daegu, Korea.
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea.
Korean J Intern Med. 2025 Jan;40(1):115-123. doi: 10.3904/kjim.2024.041. Epub 2025 Jan 1.
BACKGROUND/AIMS: Multiple myeloma (MM) predominantly affects elderly individuals, but studies on older patients with MM are limited. The clinical characteristics and survival outcomes of patients with MM aged 80 years or over were retrospectively analyzed.
This retrospective multicenter study was conducted to investigate the clinical characteristics, treatment patterns, and survival outcomes of patients aged 80 years or over who were newly diagnosed with MM at five academic hospitals in Daegu, Korea, between 2010 and 2019.
A total of 127 patients with a median age of 83 years (range, 80-93 yr) were enrolled: 52 (40.9%) with Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, 84 (66.1%) with International Staging System (ISS) stage III disease, and 93 (73.2%) with a Charlson comorbidity index (CCI) > 4. Chemotherapy was administered to 86 patients (67.7%). The median overall survival was 9.3 months. Overall survival was significantly associated with ECOG PS > 2 (HR 2.26, 95% CI 1.43-3.59), ISS stage III (HR 1.99, 95% CI 1.18-3.34), and chemotherapy (HR 0.34, 95% CI 0.21-0.55). There was no statistically significant difference in event-free survival according to the type of anti-myeloma chemotherapy administered. The early mortality (EM) rate was 28.3%.
Even in patients with MM aged 80 years or over, chemotherapy can result in better survival outcomes than supportive care. Patients aged ≥ 80 years should not be excluded from chemotherapy based on age alone. However, reducing EM in elderly patients with newly diagnosed MM remains challenging.
背景/目的：多发性骨髓瘤（MM）主要影响老年人，但针对老年MM患者的研究有限。对80岁及以上MM患者的临床特征和生存结局进行了回顾性分析。
本回顾性多中心研究旨在调查2010年至2019年期间在韩国大邱的五家学术医院新诊断为MM的80岁及以上患者的临床特征、治疗模式和生存结局。
共纳入127例患者，中位年龄83岁（范围80 - 93岁）：52例（40.9%）东部肿瘤协作组体能状态（ECOG PS）>2，84例（66.1%）国际分期系统（ISS）III期疾病，93例（73.2%）Charlson合并症指数（CCI）>4。86例患者（67.7%）接受了化疗。中位总生存期为9.3个月。总生存期与ECOG PS>2（HR 2.26，95%CI 1.43 - 3.59）、ISS III期（HR 1.99，95%CI 1.18 - 3.34）和化疗（HR 0.34，95%CI 0.21 - 0.55）显著相关。根据所给予的抗骨髓瘤化疗类型，无事件生存期无统计学显著差异。早期死亡率（EM）为28.3%。
即使是80岁及以上的MM患者，化疗也能比支持治疗带来更好的生存结局。不应仅基于年龄就将80岁及以上的患者排除在化疗之外。然而，降低新诊断MM老年患者的EM仍然具有挑战性。
