Multiple Myeloma In Patients Younger Than50Years:a Retrospective Survival Analysis

Objective:This study is a single center retrospective analysis designed to evaluate the influence of various prognostic factors on survival of younger patients with multiple myeloma (MM). The efficacy of chemotherapy alone or followed by autologous hematopoietic stem cell transplantation (ASCT) remains to be determined.Methods:We collected and analyzed the clinical data of57patients with MM younger than50years at diagnosis. Univariate and multivariate analyses were performed to evaluate14clinical or laboratory parameters affecting survival.. Response rate, overall survival (OS) and progression free survival (PFS) were retrospectively calculated.Results:Factors adversely affecting OS were β2-MG level>3.5mg/L, C-reactive protein level>6.0mg/L, whereas ASCT was the protective factor. For PFS, albumin level<35g/L, calcium level>2.58mmol/L and plasma cell percentage>30%were the adverse factors, and ASCT was the protective factor. Among them, CRP was the only independent prognostic factor for poor survival, and ASCT was the protective factor. The ORR (overall response rate, defined as> partial response) for all the57patients was87.7%(50/57),>VGPR (very good partial response) rate was64.9%(37/57), and the CR rate was35.1%(20/57). The median OS and PFS were61.0months (95%CI22-100) and21.0months (95%CI12-30), respectively. ASCT group had higher> VGPR rate(100%vs.56.5%, p=0.007)and CR rate (90.9%vs.21.7%, p=0.000) than that without ASCT. Compared with chemotherapy alone, ASCT significantly prolonged the OS (not reached vs.37.0months, p=0.005) and PFS (56.0vs.15.0months, p=0.001).Conclusion:It is still feasible to predict survival based on the conventional prognostic factors in younger patients with multiple myeloma. For MM patients younger than50years, ASCT leads to significantly higher response rate, longer OS and PFS than chemotherapy alone.