Okayama Yusuke, Takakuwa Teruhito, Shimura Yuji, Imada Kazunori, Kosugi Satoru, Hotta Masaaki, Fuchida Shin-Ichi, Tanaka Hirokazu, Uoshima Nobuhiko, Yoshihara Satoshi, Kanda Junya, Shibayama Hirohiko, Fukushima Kentaro, Ohta Kensuke, Yagi Hideo, Ito Tomoki, Shimazaki Chihiro, Matsumura Itaru, Takaori-Kondo Akifumi, Hosen Naoki, Hino Masayuki, Kuroda Junya
Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Department of Hematology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hematology. 2025 Dec;30(1):2496545. doi: 10.1080/16078454.2025.2496545. Epub 2025 Apr 28.
With the aging population, there is a growing need for treating multiple myeloma (MM) in elderly patients; however, real-world studies of them are quite limited.
We retrospectively analyzed 519 patients diagnosed between 1997 and 2020 in the Kansai Myeloma Forum database to evaluate the efficacy and safety of novel agents available for 80 years and older patients with MM. Patients were divided into groups according to the treatment year: up to 2010 (Group 1), 2011-2015 (Group 2), and 2016-2020 (Group 3).
The median age and number of treatment lines were 83 years (range, 80-96) and 2, respectively. The median time to next treatment (TTNT) was 7.8 months. The TTNT for Group 3 was significantly shorter (3.8 months) than in other groups ( < 0.001). Median progression free survival and overall survival (OS) were 24.4 and 43.7 months, respectively, and did not differ significantly between 3 groups based on pairwise comparisons. In Group 3, the 1-year cumulative incidence of adverse events (AEs), progression or death, and planned treatment leading to treatment discontinuation was 37.7%, 29.4%, and 15.6%, respectively. In addition, the median time until discontinuation due to AEs has been shortened in recent years.
Our findings suggest that AEs threaten the continued treatment of very elderly patients receiving novel agents, with careful management needed to extend the TTNT.
