Chromosomal abnormalities are major prognostic factors in elderly patients with multiple myeloma: the intergroupe francophone du myélome experience

染色体异常是老年多发性骨髓瘤患者的主要预后因素:法语国家骨髓瘤患者群体的经验

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作者:Hervé Avet-Loiseau, Cyrille Hulin, Loic Campion, Philippe Rodon, Gerald Marit, Michel Attal, Bruno Royer, Mamoun Dib, Laurent Voillat, Didier Bouscary, Denis Caillot, Marc Wetterwald, Brigitte Pegourie, Gerard Lepeu, Bernadette Corront, Lionel Karlin, Anne-Marie Stoppa, Jean-Gabriel Fuzibet, Xavier

Conclusion

t(4;14) and del(17p) are major prognostic factors in elderly patients with MM, both for progression-free and overall survival, indicating that these two abnormalities should be investigated at diagnosis of MM, regardless of age.

Methods

To answer this important question, we retrospectively analyzed a series of 1,890 patients (median age, 72 years; range, 66 to 94 years), including 1,095 with updated data on treatment modalities and survival.

Purpose

Chromosomal abnormalities, especially t(4;14) and del(17p), are major prognostic factors in patients with multiple myeloma (MM). However, this has been especially demonstrated in patients age < 66 years treated with intensive approaches. The goal of this study was to address this issue in elderly patients treated with conventional-dose chemotherapy. Patients and

Results

This large study first showed that the incidence of t(4;14) was not uniform over age, with a marked decrease in the oldest patients. Second, it showed that both t(4;14) and del(17p) retained their prognostic value in elderly patients treated with melphalan and prednisone-based chemotherapy.

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