Impact of age on survival after intensive therapy for multiple myeloma:: a population-based study by the Nordic Myeloma Study Group
Impact of age on survival after intensive therapy for multiple myeloma:: a population-based study by the Nordic Myeloma Study Group
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DOI：
10.1111/j.1365-2141.2006.06042.x
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发表时间：
2006-05-01
影响因子：
6.5
通讯作者：
Turesson, I
中科院分区：
文献类型：
--
作者：
Lenhoff, S;Hjorth, M;Turesson, I
包括自体干细胞移植在内的强化治疗在60岁以上新诊断骨髓瘤患者中的价值尚不清楚。我们在前瞻性的、基于人群的环境中评估了年龄（< 60岁与60-64岁）对生存率的影响，并将生存率与传统治疗的历史对照进行了比较。前瞻性人群包括1998年至2000年间登记的452例患者。其中414人接受了强化治疗。历史人群来自我们最近的基于人群的常规治疗研究，包括281例患者。其中，243人符合我们的强化治疗资格标准。对于接受强化治疗的患者，发现两个因素，β 2-微球蛋白和年龄< 60岁与60-64岁，对生存有独立的预后影响。然而，与历史对照组相比，60岁以下患者（中位数66个月对43个月，P < 0.001）和60-64岁患者（中位数50个月对27个月，P = 0.001）的生存率更高。我们的结论是，在一个以人群为基础的设置较高的年龄产生不利影响后，强化治疗的结果。我们的研究结果表明，强化治疗在60-64岁的患者中也能提高生存率，但与年轻患者相比优势较小。
The value of intensive therapy, including autologous stem cell transplantation, in newly diagnosed myeloma patients > 60 years is not clear. We evaluated the impact of age (< 60 years vs. 60-64 years) on survival in a prospective, population-based setting and compared survival with conventionally treated historic controls. The prospective population comprised 452 patients registered between 1998 and 2000. Of these, 414 received intensive therapy. The historic population, derived from our most recent population-based study on conventional therapy, comprised 281 patients. Of these, 243 fulfilled our eligibility criteria for intensive therapy. For patients undergoing intensive therapy it was found that two factors, beta-2-microglobulin and age < 60 years vs. 60-64 years, had independent prognostic impact on survival. However, compared with the historic controls a survival advantage was found both for patients < 60 (median 66 months vs. 43 months, P < 0.001) and 60-64 years (median 50 months vs. 27 months; P = 0.001). We conclude that in a population-based setting higher age adversely influences outcome after intensive therapy. Our results indicate that intensive therapy prolongs survival also at age 60-64 years but with less superiority than in younger patients.