>Revista de Hematología
>Year 2016, Issue 2
Alvarado-Ibarra M, Briones-Cerecero R, López-Hernández MA, Álvarez-Vera JL, Ortiz-Zepeda SM, Ramos-León EM
Results of three schemes of treatment in patients with multiple myeloma older than 65 years
Rev Hematol Mex 2016; 17 (2)
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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
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
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.
||multiple myeloma, chemotherapy, talidomide, bortezomib, progression-free survival, overall survival.
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>Revista de Hematología
>Year 2016, Issue 2