A recent study reported that long-term surviving myeloma patients are generally younger and have received and responded well to treatment with conventional chemotherapy. Dr. M. Kraj of the Institute of Hematology and Transfusion Medicine in Warsaw, Poland, presented the findings at the European Hematology Association (EHA) meeting in Barcelona last month.

Dr. Kraj and her colleagues aimed to identify common clinical and laboratory features in long-term surviving myeloma patients, as these may assist physicians in determining an accurate prognosis for other patients.

The researchers analyzed data of 600 myeloma patients diagnosed before 2000 and treated at the Institute of Hematology and Transfusion Medicine.

They found that 88 patients (14.7 percent) survived for over seven years after disease diagnosis (7.5 percent over 10 years, 1.8 percent over 15 years, and 1.1 percent over 20 years).

In general, the long-term surviving patients were younger than the overall patient group, with a median age of 55 years. Additionally, the patients had normal creatinine, calcium, and beta-2 microglobulin levels in the blood. Elevated levels of these chemicals are commonly associated with disease-related complications, such as bone degradation or kidney dysfunction.

Approximately 68 percent of patients showed Stage 1 or Stage 2 myeloma at diagnosis. Additionally, 60 percent had IgG monoclonal protein produced by the myeloma tumor, which is the most common immunoglobulin associated with myeloma. Fifty-eight percent of patients suffered from osteolysis, a process by which bone is broken down to release minerals such as calcium.

The majority of long-term surviving patients were treated with conventional chemotherapy. Eighteen patients were treated with melphalan ^[1] (Alkeran) only, whereas 30 patients were treated with melphalan followed by vincristine ^[2] (Oncovan), cyclophosphamide ^[3] (Cytoxan), BCNU (Carmustine), doxorubicin ^[4] (Adriamycin), and prednisone ^[5] or dexamethasone ^[6] (Decadron). Only nine patients received treatment with novel therapeutic agents, such as thalidomide ^[7] (Thalomid), Velcade ^[8] (bortezomib), or Revlimid ^[9] (lenalidomide).

Beginning from the time of diagnosis, 16 patients received treatment with several chemotherapeutic agents simultaneously, and 15 patients received radiotherapy or radiation with Cobalt-60 in addition to chemotherapy.

The researchers observed that 66 percent of patients responded well to treatment, and the remaining 34 percent achieved stable disease. Patients required an average treatment time of 10 months before achieving a partial response, and the average response to treatment lasted 70 months.

Nineteen of the long-term surviving patients are still alive, with 12 of the patients still undergoing treatment. The longest follow-up with one of these patients is 31 years after diagnosis and 25 years after beginning anti-tumor treatment.

For more information, please see the presentation abstract ^[10] at the EHA meeting ^[11] website.