Clinical characteristics of multiple myeloma (MM) in Vietnam-era (V) and non–Vietnam-era veterans (Non V).

Abstract

e18579 Background: There has been increased interest in V veterans with lymphoid malignancies. We compared the survival and severity of MM in veterans from V and non-V at a VA medical center. Methods: In an IRB -approved protocol, we reviewed the records of veterans diagnosed with MM from January 2002 to October 2010 at the VANJHCS. Records were reviewed for demographic, clinical, pathological data, Vietnam status, treatments, and survival. We tabulated the performance status (PS), International Staging System (ISS), Durie-Salmon stage, Charlson Co morbidity Index (CCI), the Kaplan-Feinstein Comorbidity Index (KFI), the Cumulative Illness Rating Scale (CIRS), and Vietnam status. We then performed Cox regression analyses and tests of proportions to determine predictors of survival. Results: There were 72 veterans who met the eligibility criteria and their data were analyzed. There were 21 V and 51 non-V. The groups did not differ in the following characteristics PS, stage, laboratory parameters and comorbidity indice. Differences in their clinical features are summarized in the table. Survival predictors for the non V veterans were the BMI (p 0.046), hemoglobin (p 0.01), alb (p 0.001), beta 2-microglobulin (p 0.003) and ISS (p 0.004) but these were not predictors of survival for V veterans. Median survival for V veterans was 840 days (91-4654) and Non V was 766 days (464-1995) (p<0.0001). Conclusions: The V veterans were younger than the Non V veterans and their survival was better. This difference could be due to evolution of newer treatments. Further research is needed in a bigger sample to explain these differences. Parameters V Non V Age (years) Median 63 (54-86) 77 (40-90) P <0.0001 Race (AA) 13/21 22/51 P 0.07 Survival (days) 840 (91-4654) 766 (26-3284) P <0.0001