Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival : an analysis of 10 549 patients from the International Myeloma Working Group
Identifieur interne : 008B76 ( Main/Exploration ); précédent : 008B75; suivant : 008B77Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival : an analysis of 10 549 patients from the International Myeloma Working Group
Auteurs : Heinz Ludwig [Autriche] ; Brian G. M. Durie [États-Unis] ; Vanessa Bolejack [États-Unis] ; Ingemar Turesson [Suède] ; Robert A. Kyle [États-Unis] ; Joan Blade [Espagne] ; Rafael Fonseca [États-Unis] ; Meletios Dimopoulos [Grèce] ; Kazuyuki Shimizu [Japon] ; Jesus San Miguel [Espagne] ; Jan Westin [Suède] ; Jean-Luc Harousseau [France] ; Meral Beksac [Turquie] ; Mario Boccadoro [Italie] ; Antonio Palumbo [Italie] ; Bart Barlogie [États-Unis] ; Chaim Shustik [États-Unis] ; Michele Cavo [Italie] ; Philip R. Greipp [États-Unis] ; Douglas Joshua [Australie] ; Michel Attal [France] ; Pieter Sonneveld [Pays-Bas] ; John Crowley [États-Unis]Source :
- Blood [ 0006-4971 ] ; 2008.
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- Pascal (Inist)
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- topic : Homme.
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Abstract
We analyzed the presenting features and survival in 1689 patients with multiple myeloma aged younger than 50 years compared with 8860 patients 50 years of age and older. Of the total 10 549 patients, 7765 received conventional therapy and 2784 received high-dose therapy. Young patients were more frequently male, had more favorable features such as low International Staging System (ISS) and Durie-Salmon stage as well as less frequently adverse prognostic factors including high C-reactive protein (CRP), low hemoglobin, increased serum creatinine, and poor performance status. Survival was significantly longer in young patients (median, 5.2 years vs 3.7 years; P<.001) both after conventional (median, 4.5 years vs 3.3 years; P <.001) or high-dose therapy (median, 7.5 years vs 5.7 years; P =.04). The 10-year survival rate was 19% after conventional therapy and 43% after high-dose therapy in young patients, and 8% and 29%, respectively, in older patients. Multivariate analysis revealed age as an independent risk factor during conventional therapy, but not after autologous transplantation. A total of 5 of the 10 independent risk factors identified for conventional therapy were also relevant for autologous transplantation. After adjusting for normal mortality, lower ISS stage and other favorable prognostic features seem to account for the significantly longer survival of young patients with multiple myeloma with age remaining a risk factor during conventional therapy.
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Affiliations:
- Australie, Autriche, Espagne, France, Grèce, Italie, Japon, Pays-Bas, Suède, Turquie, États-Unis
- Attique (région), Catalogne, Hollande-Méridionale, Midi-Pyrénées, Occitanie (région administrative), Pays de la Loire, Piémont, Québec, Vienne (Autriche)
- Athènes, Barcelone, Montréal, Nantes, Rotterdam, Toulouse, Turin, Vienne (Autriche)
- Université McGill
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Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival : an analysis of 10 549 patients from the International Myeloma Working Group</title><author><name sortKey="Ludwig, Heinz" sort="Ludwig, Heinz" uniqKey="Ludwig H" first="Heinz" last="Ludwig">Heinz Ludwig</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Medicine, Wilhelminenspital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>1 aut.</sZ></inist:fA14><country>Autriche</country><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Bolejack, Vanessa" sort="Bolejack, Vanessa" uniqKey="Bolejack V" first="Vanessa" last="Bolejack">Vanessa Bolejack</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Cancer Research and Biostatistics</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cancer Research and Biostatistics</wicri:noRegion></affiliation></author><author><name sortKey="Turesson, Ingemar" sort="Turesson, Ingemar" uniqKey="Turesson I" first="Ingemar" last="Turesson">Ingemar Turesson</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Hematology, University Hospital</s1><s2>Malmö</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Malmö</wicri:noRegion></affiliation></author><author><name sortKey="Kyle, Robert A" sort="Kyle, Robert A" uniqKey="Kyle R" first="Robert A." last="Kyle">Robert A. Kyle</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Division of Hematology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Blade, Joan" sort="Blade, Joan" uniqKey="Blade J" first="Joan" last="Blade">Joan Blade</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Institut d' Investigacious Biomediques August Pi i Sunyer</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>6 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Fonseca, Rafael" sort="Fonseca, Rafael" uniqKey="Fonseca R" first="Rafael" last="Fonseca">Rafael Fonseca</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Division of Hematology and Oncology, Mayo Clinic Comprehensive Cancer Center</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Scottsdale, AZ</wicri:noRegion></affiliation></author><author><name sortKey="Dimopoulos, Meletios" sort="Dimopoulos, Meletios" uniqKey="Dimopoulos M" first="Meletios" last="Dimopoulos">Meletios Dimopoulos</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Department of Clinical Therapeutics, University of Athens School of Medicine</s1><s2>Athens</s2><s3>GRC</s3><sZ>8 aut.</sZ></inist:fA14><country>Grèce</country><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Shimizu, Kazuyuki" sort="Shimizu, Kazuyuki" uniqKey="Shimizu K" first="Kazuyuki" last="Shimizu">Kazuyuki Shimizu</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Medicine, Nagoya City Midori General Hospital</s1><s2>Nagoya</s2><s3>JPN</s3><sZ>9 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nagoya</wicri:noRegion></affiliation></author><author><name sortKey="San Miguel, Jesus" sort="San Miguel, Jesus" uniqKey="San Miguel J" first="Jesus" last="San Miguel">Jesus San Miguel</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University Hospital of Salamanca</s1><s2>Salamanca</s2><s3>ESP</s3><sZ>10 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>University Hospital of Salamanca</wicri:noRegion></affiliation></author><author><name sortKey="Westin, Jan" sort="Westin, Jan" uniqKey="Westin J" first="Jan" last="Westin">Jan Westin</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Hematology, University Hospital</s1><s2>Lund</s2><s3>SWE</s3><sZ>11 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Harousseau, Jean Luc" sort="Harousseau, Jean Luc" uniqKey="Harousseau J" first="Jean-Luc" last="Harousseau">Jean-Luc Harousseau</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Division of Hematology, Centre Hospitalier Universitaire Hotel-Dieu</s1><s2>Nantes</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital</s1><s2>Ankara</s2><s3>TUR</s3><sZ>13 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Boccadoro, Mario" sort="Boccadoro, Mario" uniqKey="Boccadoro M" first="Mario" last="Boccadoro">Mario Boccadoro</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Divisione Universitaria di Ematologia, Ospedale Molinette</s1><s2>Torino</s2><s3>ITA</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Divisione Universitaria di Ematologia, Ospedale Molinette</s1><s2>Torino</s2><s3>ITA</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Barlogie, Bart" sort="Barlogie, Bart" uniqKey="Barlogie B" first="Bart" last="Barlogie">Bart Barlogie</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Little Rock, AR</wicri:noRegion></affiliation></author><author><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>Department of Medicine, McGill University</s1><s2>Montreal, QC</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName><orgName type="university">Université McGill</orgName></affiliation></author><author><name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Institute of Hematology and Medical Oncology Seragnoli, University of Bologna</s1><s2>Bologna</s2><s3>ITA</s3><sZ>18 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Greipp, Philip R" sort="Greipp, Philip R" uniqKey="Greipp P" first="Philip R." last="Greipp">Philip R. Greipp</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Division of Hematology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Joshua, Douglas" sort="Joshua, Douglas" uniqKey="Joshua D" first="Douglas" last="Joshua">Douglas Joshua</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Institute of Haematology, Royal Prince Alfred Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>20 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Michel" sort="Attal, Michel" uniqKey="Attal M" first="Michel" last="Attal">Michel Attal</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>Service d'Hématologie, Hôpital Purpan</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name><affiliation wicri:level="3"><inist:fA14 i1="20"><s1>Department of Hematology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>22 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Crowley, John" sort="Crowley, John" uniqKey="Crowley J" first="John" last="Crowley">John Crowley</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Cancer Research and Biostatistics</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cancer Research and Biostatistics</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0314278</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0314278 INIST</idno><idno type="RBID">Pascal:08-0314278</idno><idno type="wicri:Area/PascalFrancis/Corpus">003463</idno><idno type="wicri:Area/PascalFrancis/Curation">002B86</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003054</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003054</idno><idno type="wicri:doubleKey">0006-4971:2008:Ludwig H:myeloma:in:patients</idno><idno type="wicri:Area/Main/Merge">009468</idno><idno type="wicri:source">PMC</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259800</idno><idno type="RBID">PMC:4259800</idno><idno type="wicri:Area/Pmc/Corpus">001793</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001793</idno><idno type="wicri:Area/Pmc/Curation">001653</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001653</idno><idno type="wicri:Area/Pmc/Checkpoint">002958</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002958</idno><idno type="wicri:Area/Ncbi/Merge">000345</idno><idno type="wicri:Area/Ncbi/Curation">000345</idno><idno type="wicri:Area/Ncbi/Checkpoint">000345</idno><idno type="wicri:doubleKey">0006-4971:2008:Ludwig H:myeloma:in:patients</idno><idno type="wicri:Area/Main/Merge">008E11</idno><idno type="wicri:Area/Main/Curation">008B76</idno><idno type="wicri:Area/Main/Exploration">008B76</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival : an analysis of 10 549 patients from the International Myeloma Working Group</title><author><name sortKey="Ludwig, Heinz" sort="Ludwig, Heinz" uniqKey="Ludwig H" first="Heinz" last="Ludwig">Heinz Ludwig</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Medicine, Wilhelminenspital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>1 aut.</sZ></inist:fA14><country>Autriche</country><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Los Angeles, CA</wicri:noRegion></affiliation></author><author><name sortKey="Bolejack, Vanessa" sort="Bolejack, Vanessa" uniqKey="Bolejack V" first="Vanessa" last="Bolejack">Vanessa Bolejack</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Cancer Research and Biostatistics</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cancer Research and Biostatistics</wicri:noRegion></affiliation></author><author><name sortKey="Turesson, Ingemar" sort="Turesson, Ingemar" uniqKey="Turesson I" first="Ingemar" last="Turesson">Ingemar Turesson</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Hematology, University Hospital</s1><s2>Malmö</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Malmö</wicri:noRegion></affiliation></author><author><name sortKey="Kyle, Robert A" sort="Kyle, Robert A" uniqKey="Kyle R" first="Robert A." last="Kyle">Robert A. Kyle</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Division of Hematology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Blade, Joan" sort="Blade, Joan" uniqKey="Blade J" first="Joan" last="Blade">Joan Blade</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Institut d' Investigacious Biomediques August Pi i Sunyer</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>6 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Fonseca, Rafael" sort="Fonseca, Rafael" uniqKey="Fonseca R" first="Rafael" last="Fonseca">Rafael Fonseca</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Division of Hematology and Oncology, Mayo Clinic Comprehensive Cancer Center</s1><s2>Scottsdale, AZ</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Scottsdale, AZ</wicri:noRegion></affiliation></author><author><name sortKey="Dimopoulos, Meletios" sort="Dimopoulos, Meletios" uniqKey="Dimopoulos M" first="Meletios" last="Dimopoulos">Meletios Dimopoulos</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Department of Clinical Therapeutics, University of Athens School of Medicine</s1><s2>Athens</s2><s3>GRC</s3><sZ>8 aut.</sZ></inist:fA14><country>Grèce</country><placeName><settlement type="city">Athènes</settlement><region nuts="2" type="region">Attique (région)</region></placeName></affiliation></author><author><name sortKey="Shimizu, Kazuyuki" sort="Shimizu, Kazuyuki" uniqKey="Shimizu K" first="Kazuyuki" last="Shimizu">Kazuyuki Shimizu</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Medicine, Nagoya City Midori General Hospital</s1><s2>Nagoya</s2><s3>JPN</s3><sZ>9 aut.</sZ></inist:fA14><country>Japon</country><wicri:noRegion>Nagoya</wicri:noRegion></affiliation></author><author><name sortKey="San Miguel, Jesus" sort="San Miguel, Jesus" uniqKey="San Miguel J" first="Jesus" last="San Miguel">Jesus San Miguel</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University Hospital of Salamanca</s1><s2>Salamanca</s2><s3>ESP</s3><sZ>10 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>University Hospital of Salamanca</wicri:noRegion></affiliation></author><author><name sortKey="Westin, Jan" sort="Westin, Jan" uniqKey="Westin J" first="Jan" last="Westin">Jan Westin</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Department of Hematology, University Hospital</s1><s2>Lund</s2><s3>SWE</s3><sZ>11 aut.</sZ></inist:fA14><country>Suède</country><wicri:noRegion>Lund</wicri:noRegion></affiliation></author><author><name sortKey="Harousseau, Jean Luc" sort="Harousseau, Jean Luc" uniqKey="Harousseau J" first="Jean-Luc" last="Harousseau">Jean-Luc Harousseau</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Division of Hematology, Centre Hospitalier Universitaire Hotel-Dieu</s1><s2>Nantes</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital</s1><s2>Ankara</s2><s3>TUR</s3><sZ>13 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Boccadoro, Mario" sort="Boccadoro, Mario" uniqKey="Boccadoro M" first="Mario" last="Boccadoro">Mario Boccadoro</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Divisione Universitaria di Ematologia, Ospedale Molinette</s1><s2>Torino</s2><s3>ITA</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Divisione Universitaria di Ematologia, Ospedale Molinette</s1><s2>Torino</s2><s3>ITA</s3><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="Barlogie, Bart" sort="Barlogie, Bart" uniqKey="Barlogie B" first="Bart" last="Barlogie">Bart Barlogie</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Little Rock, AR</wicri:noRegion></affiliation></author><author><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>Department of Medicine, McGill University</s1><s2>Montreal, QC</s2><s3>USA</s3><sZ>17 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Montréal</settlement><region type="state">Québec</region></placeName><orgName type="university">Université McGill</orgName></affiliation></author><author><name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name><affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Institute of Hematology and Medical Oncology Seragnoli, University of Bologna</s1><s2>Bologna</s2><s3>ITA</s3><sZ>18 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Greipp, Philip R" sort="Greipp, Philip R" uniqKey="Greipp P" first="Philip R." last="Greipp">Philip R. Greipp</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Division of Hematology, Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Rochester, MN</wicri:noRegion></affiliation></author><author><name sortKey="Joshua, Douglas" sort="Joshua, Douglas" uniqKey="Joshua D" first="Douglas" last="Joshua">Douglas Joshua</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Institute of Haematology, Royal Prince Alfred Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>20 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Michel" sort="Attal, Michel" uniqKey="Attal M" first="Michel" last="Attal">Michel Attal</name><affiliation wicri:level="3"><inist:fA14 i1="19"><s1>Service d'Hématologie, Hôpital Purpan</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name><affiliation wicri:level="3"><inist:fA14 i1="20"><s1>Department of Hematology, Erasmus MC</s1><s2>Rotterdam</s2><s3>NLD</s3><sZ>22 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Crowley, John" sort="Crowley, John" uniqKey="Crowley J" first="John" last="Crowley">John Crowley</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Cancer Research and Biostatistics</s1><s2>Seattle, WA</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Cancer Research and Biostatistics</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Blood</title><title level="j" type="abbreviated">Blood</title><idno type="ISSN">0006-4971</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age</term><term>B cell neoplasm</term><term>Hematology</term><term>Human</term><term>International</term><term>Lymphoid neoplasm</term><term>Myeloma</term><term>Survival</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Myélome</term><term>Homme</term><term>Age</term><term>Survie</term><term>International</term><term>Hématologie</term><term>Hémopathie maligne lymphoïde</term><term>Hémopathie lymphoïde B</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We analyzed the presenting features and survival in 1689 patients with multiple myeloma aged younger than 50 years compared with 8860 patients 50 years of age and older. Of the total 10 549 patients, 7765 received conventional therapy and 2784 received high-dose therapy. Young patients were more frequently male, had more favorable features such as low International Staging System (ISS) and Durie-Salmon stage as well as less frequently adverse prognostic factors including high C-reactive protein (CRP), low hemoglobin, increased serum creatinine, and poor performance status. Survival was significantly longer in young patients (median, 5.2 years vs 3.7 years; P<.001) both after conventional (median, 4.5 years vs 3.3 years; P <.001) or high-dose therapy (median, 7.5 years vs 5.7 years; P =.04). The 10-year survival rate was 19% after conventional therapy and 43% after high-dose therapy in young patients, and 8% and 29%, respectively, in older patients. Multivariate analysis revealed age as an independent risk factor during conventional therapy, but not after autologous transplantation. A total of 5 of the 10 independent risk factors identified for conventional therapy were also relevant for autologous transplantation. After adjusting for normal mortality, lower ISS stage and other favorable prognostic features seem to account for the significantly longer survival of young patients with multiple myeloma with age remaining a risk factor during conventional therapy.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Autriche</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Japon</li><li>Pays-Bas</li><li>Suède</li><li>Turquie</li><li>États-Unis</li></country><region><li>Attique (région)</li><li>Catalogne</li><li>Hollande-Méridionale</li><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li><li>Pays de la Loire</li><li>Piémont</li><li>Québec</li><li>Vienne (Autriche)</li></region><settlement><li>Athènes</li><li>Barcelone</li><li>Montréal</li><li>Nantes</li><li>Rotterdam</li><li>Toulouse</li><li>Turin</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université McGill</li></orgName></list><tree><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Ludwig, Heinz" sort="Ludwig, Heinz" uniqKey="Ludwig H" first="Heinz" last="Ludwig">Heinz Ludwig</name></region></country><country name="États-Unis"><noRegion><name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name></noRegion><name sortKey="Barlogie, Bart" sort="Barlogie, Bart" uniqKey="Barlogie B" first="Bart" last="Barlogie">Bart Barlogie</name><name sortKey="Bolejack, Vanessa" sort="Bolejack, Vanessa" uniqKey="Bolejack V" first="Vanessa" last="Bolejack">Vanessa Bolejack</name><name sortKey="Crowley, John" sort="Crowley, John" uniqKey="Crowley J" first="John" last="Crowley">John Crowley</name><name sortKey="Fonseca, Rafael" sort="Fonseca, Rafael" uniqKey="Fonseca R" first="Rafael" last="Fonseca">Rafael Fonseca</name><name sortKey="Greipp, Philip R" sort="Greipp, Philip R" uniqKey="Greipp P" first="Philip R." last="Greipp">Philip R. Greipp</name><name sortKey="Kyle, Robert A" sort="Kyle, Robert A" uniqKey="Kyle R" first="Robert A." last="Kyle">Robert A. Kyle</name><name sortKey="Shustik, Chaim" sort="Shustik, Chaim" uniqKey="Shustik C" first="Chaim" last="Shustik">Chaim Shustik</name></country><country name="Suède"><noRegion><name sortKey="Turesson, Ingemar" sort="Turesson, Ingemar" uniqKey="Turesson I" first="Ingemar" last="Turesson">Ingemar Turesson</name></noRegion><name sortKey="Westin, Jan" sort="Westin, Jan" uniqKey="Westin J" first="Jan" last="Westin">Jan Westin</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Blade, Joan" sort="Blade, Joan" uniqKey="Blade J" first="Joan" last="Blade">Joan Blade</name></region><name sortKey="San Miguel, Jesus" sort="San Miguel, Jesus" uniqKey="San Miguel J" first="Jesus" last="San Miguel">Jesus San Miguel</name></country><country name="Grèce"><region name="Attique (région)"><name sortKey="Dimopoulos, Meletios" sort="Dimopoulos, Meletios" uniqKey="Dimopoulos M" first="Meletios" last="Dimopoulos">Meletios Dimopoulos</name></region></country><country name="Japon"><noRegion><name sortKey="Shimizu, Kazuyuki" sort="Shimizu, Kazuyuki" uniqKey="Shimizu K" first="Kazuyuki" last="Shimizu">Kazuyuki Shimizu</name></noRegion></country><country name="France"><region name="Pays de la Loire"><name sortKey="Harousseau, Jean Luc" sort="Harousseau, Jean Luc" uniqKey="Harousseau J" first="Jean-Luc" last="Harousseau">Jean-Luc Harousseau</name></region><name sortKey="Attal, Michel" sort="Attal, Michel" uniqKey="Attal M" first="Michel" last="Attal">Michel Attal</name></country><country name="Turquie"><noRegion><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name></noRegion></country><country name="Italie"><region name="Piémont"><name sortKey="Boccadoro, Mario" sort="Boccadoro, Mario" uniqKey="Boccadoro M" first="Mario" last="Boccadoro">Mario Boccadoro</name></region><name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name><name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name></country><country name="Australie"><noRegion><name sortKey="Joshua, Douglas" sort="Joshua, Douglas" uniqKey="Joshua D" first="Douglas" last="Joshua">Douglas Joshua</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Myeloma in patients younger than age 50 years presents with more favorable features and shows better survival : an analysis of 10 549 patients from the International Myeloma Working Group
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