Korean J Intern Med.  2025 Jan;40(1):115-123. 10.3904/kjim.2024.041.

The characteristics of Korean elderly multiple myeloma patients aged 80 years or over

Affiliations
  • 1Department of Hematology/Oncology, Daegu Fatima Hospital, Daegu, Korea
  • 2Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea
  • 3Department of Hematology/Oncology, Yeungnam University Medical Center, Daegu, Korea
  • 4Department of Hematology/Oncology, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 5Department of Hematology/Oncology, Daegu Catholic University Medical Center, Daegu, Korea

Abstract

Background/Aims
Multiple myeloma (MM) predominantly affects elderly individuals, but studies on older patients with MM are limited. The clinical characteristics and survival outcomes of patients with MM aged 80 years or over were retrospectively analyzed.
Methods
This retrospective multicenter study was conducted to investigate the clinical characteristics, treatment patterns, and survival outcomes of patients aged 80 years or over who were newly diagnosed with MM at five academic hospitals in Daegu, Korea, between 2010 and 2019.
Results
A total of 127 patients with a median age of 83 years (range, 80–93 yr) were enrolled: 52 (40.9%) with Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, 84 (66.1%) with International Staging System (ISS) stage III disease, and 93 (73.2%) with a Charlson comorbidity index (CCI) > 4. Chemotherapy was administered to 86 patients (67.7%). The median overall survival was 9.3 months. Overall survival was significantly associated with ECOG PS > 2 (HR 2.26, 95% CI 1.43–3.59), ISS stage III (HR 1.99, 95% CI 1.18–3.34), and chemotherapy (HR 0.34, 95% CI 0.21–0.55). There was no statistically significant difference in event-free survival according to the type of anti-myeloma chemotherapy administered. The early mortality (EM) rate was 28.3%.
Conclusions
Even in patients with MM aged 80 years or over, chemotherapy can result in better survival outcomes than supportive care. Patients aged ≥ 80 years should not be excluded from chemotherapy based on age alone. However, reducing EM in elderly patients with newly diagnosed MM remains challenging.

Keyword

Multiple myeloma; Elderly; Chemotherapy
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