Treatment of Patients with Multiple Myeloma Over 65 Yr: More Tolerability or Better Response?

Abstract

ObjectiveTwo-thirds of newly diagnosed patients with multiple myeloma (MM) are over 65yr and/or physically unfit. Such patients are not eligible for high-dose chemotherapy or stem cell transplantation. The treatment aims in these patients should be to prolong survival by obtaining the best possible response, while maintaining good tolerability. The aim of our study was to evaluate the response to treatment and treatment-related toxicities in patients treated with conventional and novel protocols.

MethodsThe records of 138 elderly (65yr) patients with MM were retrospectively evaluated.

ResultsThe median overall survival(OS) of the patients was 46months. The median progression-free survival (PFS) was 18months. The OS and PFS of the patients treated with the conventional protocols did not differ significantly from those treated with the novel protocols. The statistical analysis of the quality of the response to the treatment with the conventional and novel therapies showed that complete remission (CR), combined with a very good partial response (VGPR), was significantly higher in the latter. However, the toxicities were higher in the novel treatment group.

ConclusionThe novel drug protocols significantly increased the quality of the responses of elderly patients with MM to therapy, but they did not increase the patients' tolerability.