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Epidemiological landscape of young patients with multiple myeloma diagnosed before 40 years of age: the French experience

Alexis Caulier 1 Murielle Roussel 2 Pierre Morel 1 Naelle Lombion Benoit Branco Jean Galtier 3 Cyrille Hulin 3 Aurore Perrot 4 Valentine Richez 5 Anne-Victoire Michaud 6 Cyrille Touzeau 7, 8, 9, 10 Chantal Doyen Clara Mariette 11 Denis Caillot 12 Stephanie Harel 13 Pascal Lenain 14 Sarah Ivanoff 15 Jean Fontan 16 Anne-Marie Stoppa 17 Salomon Manier 18 Laurent Garderet 19 Xavier Leleu 20 Jean-Pierre Marolleau 1, 21 Bertrand Arnulf 22 Herve Avet-Loiseau 4 Bruno Royer 1 
Abstract : Multiple myeloma (MM) is rare in young patients, especially before age 40 years at diagnosis, representing <2% of all patients with MM. Little is known about the disease characteristics and prognosis of these patients. In this study, we examined 214 patients diagnosed with MM at age <= 40 years over 15 years, in the era of modern treatments. Among them, 189 patients had symptomatic MM. Disease characteristics were similar to older patients: 35% had anemia, 17% had renal impairment, and 13% had hypercalcemia. The staging was ISS-1 in 52.4%, ISS-2 in 27.5%, and ISS-3 in 20.1%. Overall, 18% of patients had high-risk cytogenetics [del 17p and/or t(4;14)]. Ninety percent of patients received intensive chemotherapy followed by autologous stem cell transplant, and 25% of patients had allogeneic stem cell transplant predominantly at time of relapse. The median follow-up was 76 months, the estimated median overall survival was 14.5 years, and the median progression free-survival was 41 months. In multivariate analysis, bone lesions (hazard ratio [HR], 3.95; P =.01), high ISS score (HR, 2.14; P =.03), and high-risk cytogenetics (HR, 4.54; P <.0001) were significant risk factors for poor outcomes. Among predefined time-dependent covariables, onset of progression (HR, 13.2; P <.0001) significantly shortened overall survival. At 5 years, relative survival compared with same age- and sexmatched individuals was 83.5%, and estimated standardized mortality ratio was 69.9 (95% confidence interval, 52.7-91.1), confirming that MM dramatically shortens the survival of young patients despite an extended survival after diagnosis.
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Soumis le : jeudi 17 février 2022 - 10:08:26
Dernière modification le : samedi 3 septembre 2022 - 14:28:27



Alexis Caulier, Murielle Roussel, Pierre Morel, Naelle Lombion, Benoit Branco, et al.. Epidemiological landscape of young patients with multiple myeloma diagnosed before 40 years of age: the French experience. Blood, American Society of Hematology, 2021, 138 (25), pp.2686-2695. ⟨10.1182/blood.2021011285⟩. ⟨hal-03578209⟩



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