Evaluating treatments and long-term outcomes for older or unfit patients with multiple myeloma

This study evaluated the treatments and long-term outcomes of older and unfit patients with newly diagnosed multiple myeloma (MM). The authors concluded that first-line therapies vary widely among patients, and high-risk patients may receive less effective treatment.

MM is a type of cancer of the bone marrow that can lead to abnormal immune cells. It is more common in older patients, with only one-third of newly diagnosed patients younger than 65. Older patients are often frail and have additional medical conditions, which makes treatment challenging.

Studies suggest that customizing treatment approaches for older patients based on a complete health assessment may be helpful. However, this is not easy to do in everyday practice. As a result, therapies and long-term outcomes vary widely.

This study looked at the treatments and outcomes of 675 patients with MM who could not receive a stem cell transplant (SCT). 114 (25.9%) patients had high-risk disease. 23.6% of patients received standard VMP (bortezomib, melphalan, prednisone) treatment. 27.4% of patients received less intense VMP, while 30.7% received other regimens containing bortezomib (Velcade).

Overall, patients remained alive for an average of 33.5 months after treatment. The average time without tumor growth or spread wash 15.3 months. Among 518 patients, 78.2% of patients had tumor shrinkage or better after treatment. 16.6% of patients had no signs of cancer after treatment (complete response).

During treatment, 293 patients needed dose adjustments. Of these, 116 patients in the low-dose VMP group (63.7%) and 65 patients in the standard VMP group (41.1%) needed dose adjustments.

Certain factors significantly influenced long-term outcomes. Patients who received standard VMP had a significantly longer survival on average than patients who received other regimens (52.2 months vs. 10.5 months). Patients who had stage I or stage II disease survived for longer than those with stage III disease. Normal LDH levels in the blood were significantly associated with longer survival than high LDH levels.

This study concluded that first-line treatments vary widely among elderly patients with MM. The authors suggest that treatments be chosen based on a careful assessment of risks and benefits.

This study looked back in time to analyze medical records data. Information might have been incomplete.