Chromosomal abnormalities are major prognostic factors in elderly patients with multiple myeloma: The Intergroupe Francophone du Myélome experience

Abstract

Purpose: Chromosomal abnormalities, especially t(4;14) and del(17p), are major prognostic factors in patients with multiple myeloma (MM). However, this has been especially demonstrated in patients age < 66 years treated with intensive approaches. The goal of this study was to address this issue in elderly patients treated with conventional-dose chemotherapy. Patients and Methods: To answer this important question, we retrospectively analyzed a series of 1,890 patients (median age, 72 years; range, 66 to 94 years), including 1,095 with updated data on treatment modalities and survival. Results: This large study first showed that the incidence of t(4;14) was not uniform over age, with a marked decrease in the oldest patients. Second, it showed that both t(4;14) and del(17p) retained their prognostic value in elderly patients treated with melphalan and prednisone-based chemotherapy. Conclusion: t(4;14) and del(17p) are major prognostic factors in elderly patients with MM, both for progressionfree and overall survival, indicating that these two abnormalities should be investigated at diagnosis of MM, regardless of age.