Alvarado-Ibarra M, Briones-Cerecero R, López-Hernández MA, Álvarez-Vera JL, Ortiz-Zepeda SM, Ramos-León EM

Language: Spanish
References: 24
Page: 90-98
PDF size: 474.07 Kb.

ABSTRACT

Background: Patients diagnosed with multiple myeloma aged 65 years is a little-studied group, where median survival have been reported between 6 and 22 months, with some poor prognostic factors not well studied, such as physical state, serum levels of creatinine or administration of many types of treatment including new therapies.
Objetive: To know the overall survival and progression-free survival in patients over 65 years, comparing three treatment regimens that included chemotherapy, thalidomide or bortezomib.
Patients and Method: A retrospective, prolective, observational, descriptive, comparative, unicenter study was done with patients diagnosed with multiple myeloma older than 65 years, in different stages of disease classified by ISS and Durie-Salmon, evaluating different variables included age, gender, ECOG, hematocrit, platelet count, serum calcium, serum creatinine, albumin, type of monoclonal component, DHL levels, history of renal failure, presence of fractures. Patients were divided into three groups according to the received chemotherapy.
Results: We studied 53 patients older than 65 years diagnosed with multiple myeloma, including since October 1999 to September 2014, with median age of 74 years (65-92), with 57% male, receiving induction schemes: 7 patients on group 1, 35 patients on group 2 and 11 patients on group 3, presenting an initial response as follows: complete remission, 32; partial response, 12; failure 2; not evaluable, 7, with statistical difference for staging by ISS stage II (p=0.044). The median of progression free survival was 17 months in group 1, 80 months on group 2, and not reached in the group 3 (p=0.03); the median of overall survival for group 1 was 34 months, 50 months for patients in group 2 and not reached for patients in group 3 (p=0.76). There were not significant differences in the incidence of neuropathy, thrombotic events or herpes infections in the three groups.
Conclusion: Treatments with thalidomide and bortezomib schemes improve both progression-free survival as well as overall survival in patients over 65 years compared with chemotherapy alone, whithout significant differences in the incidence of adverse events in the three groups.

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