The survival time of a multiple myeloma patient is strongly dependent on the patient’s age at diagnosis, according to a recent study published in the Journal of Clinical Oncology. The study, which evaluated the impact of age on disease outcome, compared the survival time (from diagnosis) between patients in different age groups and treatment regimens. Researchers also compared the life spans for patients with myeloma versus patients without myeloma.

Following diagnosis with multiple myeloma, the average survival time varies based on the type of treatment that a patient receives. For patients treated with high-dose chemotherapy and autologous transplantation, the average survival time is five to seven years. The majority of these patients are younger than 65 years old. Patients treated with conventional chemotherapy have an average survival time of three to four years. Many of the patients who are treated with conventional chemotherapy are older than 65.

In their study, researchers evaluated patient demographics and clinical data from 10,549 myeloma patients. The majority of patients (84 percent) were at least 50 years old. Sixty-six percent of patients received conventional chemotherapy as a first-line treatment, and 34 percent received high-dose therapy with autologous transplantation. Survival time was calculated from the time of diagnosis.

Researchers found a significant association between age and the classification of a patient’s disease stage, according to the International Staging System (ISS). Higher age was linked to a more advanced ISS stage.

The median survival time for all participants was 3.7 years; this observation did not differ significantly between male and female participants. However, the survival time steadily decreased as the age of the patients increased. In patients diagnosed with myeloma when they were 40 years old or younger, the median survival time was 5.1 years. The median survival time was 5.0 years for patients ages 40 to 49; 4.3 years for patients age 50 to 59; 3.3 years for patients ages 60 to 69; 2.6 years for patients ages 70 to 79; and 1.9 years for patients aged 80 years and older.

Researchers also compared the life spans for myeloma patients versus people not diagnosed with myeloma by using average life expectancy data that was adjusted for age, sex, year of diagnosis, and nationality. For all patients in the study, the average life span was 16.8 years less than the average life span for a patient without myeloma. This finding is significantly higher than the average difference in life span for patients diagnosed with all cancers (12.5 years).

The difference in life spans between myeloma patients versus people not diagnosed with myeloma decreased as the patient’s age increased. For patients diagnosed with myeloma when they were 40 years old or younger, the average lifespan was 36.1 years less than the average life span for a patient without myeloma.   The lifespan difference was 26.9 years for patients ages 40 to 49; 19.9 years for patients age 50 to 59; 13.7 years for patients ages 60 to 69; 8.1 years for patients ages 70 to 79; and 4.6 years for patients aged 80 years or older. The authors of the study suggest that this pattern is expected because the relatively short survival time of myeloma patients amounts to a greater difference in lifespan between patients and non-patients in younger age groups.

The results also revealed that patients ages 40 to 59 who were treated with high-dose chemotherapy and autologous transplantation had a greater survival time (by about two years) than patients of the same age groups treated with conventional chemotherapy. This increased survival time was not found in patients in other age groups. The authors hypothesize that patients between 40 and 59 years of age benefit most from high-dose chemotherapy and autologous transplantation, compared to patients in other age groups. However, the authors noted that this result is limited because the findings are non-randomized and retrospective.

The authors of the study conclude that age is an important risk factor for survival in multiple myeloma. Although the survival time for patients declines with age, the authors suggest that the widespread use of novel therapeutic agents (such as thalidomide [Thalomid], Velcade [bortezomib], and Revlimid [lenalidomide]), may lead to extended survival times.

For more information, please read the study in the Journal of Clinical Oncology (abstract).