Clinical characteristics and Outcomes in Multiple Myeloma Patients younger than 40 years in a non-Caucasian population.
IMW ePoster Library. Vasquez J. 09/08/21; 340666; 1088845
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Abstract
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INTRODUCTION: Multiple Myeloma has a median age at diagnosis of 65 years old. The percentage of patients diagnosed under 40 years old is relatively rare (2,2%) (1, 2). Clinical characteristics about this age group of patients was studied mainly in Caucasian population and recently in a Latin-America cooperative group that included Caucasian population. However, there is no data about an only non-Caucasian population.
Objective
To determine the clinical characteristics, response to treatment and survival.
Methods
We reviewed the medical records of patients diagnosed with Multiple Myeloma diagnosed at the National Institute of Neoplastic Diseases from 2000 to 2020 in Lima, Peru. Stratification was made based of age group, year of diagnosis and eligibility for hematopoietic stem cell transplant. Tables of relative and accumulative frequency were made.
Results
Twenty-three patients were analyzed. The median age was 35 years old (range 25-39), and 82% were male. The most frequent monoclonal component type was IgG (60.8%) followed by Ig A and light chain MM (both 17.4%). International Score System (ISS) 3 was the most frequent with 56.5%. Median hemoglobin was 11g/dl (range 4.3-16.3). 59% had anemia. 96% had lytic lesions 70%. LDH elevated was present only in two patients (9.5%). Plasmacytomas were present in 30% of cases.
11 patients (48%) received cyclophosphamide, thalidomide and dexamethasone followed by bortezomib, thalidomide and dexamethasone (26%). The overall response rate was 78%, and complete response was 30%. Nine patients (39%) received high dose therapy and autologous stem cell transplantation. Only 8% received post-transplant consolidation, and 45% received maintenance therapy. After a median of 20-month follow-up (range 1-108) the median progression-free survival (PFS) was not reached. The 5-year PFS was 88.8% (95% CI, 62.07-97.09). The median overall survival (OS) was not reached, and the 5-year OS was not 81.8% (95% CI, 52.69-93.93).
Conclusion
Peruvian patients with multiple myeloma younger than 40 years old have some features of high-risk disease as predominance of ISS score 3 and a higher prevalence of plasmacytoma compared to studies in elderly patients. The overall response rate was high, although complete response was low. Less than half of patients underwent autologous stem cell transplantation. Both the PFS and the OS are longer than previous reported in Peruvian patients although the time of follow-up was shorter due to loss to follow-up.
Objective
To determine the clinical characteristics, response to treatment and survival.
Methods
We reviewed the medical records of patients diagnosed with Multiple Myeloma diagnosed at the National Institute of Neoplastic Diseases from 2000 to 2020 in Lima, Peru. Stratification was made based of age group, year of diagnosis and eligibility for hematopoietic stem cell transplant. Tables of relative and accumulative frequency were made.
Results
Twenty-three patients were analyzed. The median age was 35 years old (range 25-39), and 82% were male. The most frequent monoclonal component type was IgG (60.8%) followed by Ig A and light chain MM (both 17.4%). International Score System (ISS) 3 was the most frequent with 56.5%. Median hemoglobin was 11g/dl (range 4.3-16.3). 59% had anemia. 96% had lytic lesions 70%. LDH elevated was present only in two patients (9.5%). Plasmacytomas were present in 30% of cases.
11 patients (48%) received cyclophosphamide, thalidomide and dexamethasone followed by bortezomib, thalidomide and dexamethasone (26%). The overall response rate was 78%, and complete response was 30%. Nine patients (39%) received high dose therapy and autologous stem cell transplantation. Only 8% received post-transplant consolidation, and 45% received maintenance therapy. After a median of 20-month follow-up (range 1-108) the median progression-free survival (PFS) was not reached. The 5-year PFS was 88.8% (95% CI, 62.07-97.09). The median overall survival (OS) was not reached, and the 5-year OS was not 81.8% (95% CI, 52.69-93.93).
Conclusion
Peruvian patients with multiple myeloma younger than 40 years old have some features of high-risk disease as predominance of ISS score 3 and a higher prevalence of plasmacytoma compared to studies in elderly patients. The overall response rate was high, although complete response was low. Less than half of patients underwent autologous stem cell transplantation. Both the PFS and the OS are longer than previous reported in Peruvian patients although the time of follow-up was shorter due to loss to follow-up.
INTRODUCTION: Multiple Myeloma has a median age at diagnosis of 65 years old. The percentage of patients diagnosed under 40 years old is relatively rare (2,2%) (1, 2). Clinical characteristics about this age group of patients was studied mainly in Caucasian population and recently in a Latin-America cooperative group that included Caucasian population. However, there is no data about an only non-Caucasian population.
Objective
To determine the clinical characteristics, response to treatment and survival.
Methods
We reviewed the medical records of patients diagnosed with Multiple Myeloma diagnosed at the National Institute of Neoplastic Diseases from 2000 to 2020 in Lima, Peru. Stratification was made based of age group, year of diagnosis and eligibility for hematopoietic stem cell transplant. Tables of relative and accumulative frequency were made.
Results
Twenty-three patients were analyzed. The median age was 35 years old (range 25-39), and 82% were male. The most frequent monoclonal component type was IgG (60.8%) followed by Ig A and light chain MM (both 17.4%). International Score System (ISS) 3 was the most frequent with 56.5%. Median hemoglobin was 11g/dl (range 4.3-16.3). 59% had anemia. 96% had lytic lesions 70%. LDH elevated was present only in two patients (9.5%). Plasmacytomas were present in 30% of cases.
11 patients (48%) received cyclophosphamide, thalidomide and dexamethasone followed by bortezomib, thalidomide and dexamethasone (26%). The overall response rate was 78%, and complete response was 30%. Nine patients (39%) received high dose therapy and autologous stem cell transplantation. Only 8% received post-transplant consolidation, and 45% received maintenance therapy. After a median of 20-month follow-up (range 1-108) the median progression-free survival (PFS) was not reached. The 5-year PFS was 88.8% (95% CI, 62.07-97.09). The median overall survival (OS) was not reached, and the 5-year OS was not 81.8% (95% CI, 52.69-93.93).
Conclusion
Peruvian patients with multiple myeloma younger than 40 years old have some features of high-risk disease as predominance of ISS score 3 and a higher prevalence of plasmacytoma compared to studies in elderly patients. The overall response rate was high, although complete response was low. Less than half of patients underwent autologous stem cell transplantation. Both the PFS and the OS are longer than previous reported in Peruvian patients although the time of follow-up was shorter due to loss to follow-up.
Objective
To determine the clinical characteristics, response to treatment and survival.
Methods
We reviewed the medical records of patients diagnosed with Multiple Myeloma diagnosed at the National Institute of Neoplastic Diseases from 2000 to 2020 in Lima, Peru. Stratification was made based of age group, year of diagnosis and eligibility for hematopoietic stem cell transplant. Tables of relative and accumulative frequency were made.
Results
Twenty-three patients were analyzed. The median age was 35 years old (range 25-39), and 82% were male. The most frequent monoclonal component type was IgG (60.8%) followed by Ig A and light chain MM (both 17.4%). International Score System (ISS) 3 was the most frequent with 56.5%. Median hemoglobin was 11g/dl (range 4.3-16.3). 59% had anemia. 96% had lytic lesions 70%. LDH elevated was present only in two patients (9.5%). Plasmacytomas were present in 30% of cases.
11 patients (48%) received cyclophosphamide, thalidomide and dexamethasone followed by bortezomib, thalidomide and dexamethasone (26%). The overall response rate was 78%, and complete response was 30%. Nine patients (39%) received high dose therapy and autologous stem cell transplantation. Only 8% received post-transplant consolidation, and 45% received maintenance therapy. After a median of 20-month follow-up (range 1-108) the median progression-free survival (PFS) was not reached. The 5-year PFS was 88.8% (95% CI, 62.07-97.09). The median overall survival (OS) was not reached, and the 5-year OS was not 81.8% (95% CI, 52.69-93.93).
Conclusion
Peruvian patients with multiple myeloma younger than 40 years old have some features of high-risk disease as predominance of ISS score 3 and a higher prevalence of plasmacytoma compared to studies in elderly patients. The overall response rate was high, although complete response was low. Less than half of patients underwent autologous stem cell transplantation. Both the PFS and the OS are longer than previous reported in Peruvian patients although the time of follow-up was shorter due to loss to follow-up.
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