Abstract
Multiple myeloma is a disease of older adults, and there are conflicting data about the presentation, treatment, and prognosis in younger age groups. The present study is designed to analyze the clinical and hematological profile and outcomes in young adults with multiple myeloma. The study is a retrospective analysis of individual patients' data. All consecutive patients with multiple myeloma aged 50 years or younger and treated in our institution between September 2007 and December 2020 were reviewed. Data were collected from patients' electronic medical records. A total of 175 patients were reviewed, 115 (65.7%) were male, 47 (26.8%) were smokers, and the median age was 45 (range: 24-50). At diagnosis, 73.1% of the patients presented at International Staging System (ISS) stage I-II, lytic bone lesions presented in 81.7% of the cohort, and anemia presented in 46.9%. The median M component is 3.20, 28 had no serum M component, and 74 had no serum or urine M protein. IgG Kappa 73 (41.7) and Free Kappa 40 (22.8) represent the majority of the protein isotype. The median bone marrow involvement is 60%, 14.3% (25/175) did cytogenic testing, and the most common abnormality is 4:14. VTD is the most commonly used induction regimen, 109 (62%) underwent ASCT, and 42 had relapse. The outcome is as follows: CR, 56 (32); DP, 26 (14.8); PR, 43 (24.6); SD, 5 (2.8); VGPR, 35 (20); <PR, 8 (4.6). After a median follow-up of 73 months, 61.1% of patients were still alive. Ninety-four patients of the population (53.7%) had experienced disease progression or/and death, and 62.3% of patients underwent autologous stem cell transplantation with a median overall survival (OS) of 118 months versus 24 months for those who did not. The OS for patients with ASCT was 75.2% versus 37.9% for those without (P<0.0001). There is a need for more research focusing on multiple myeloma in young patients regarding epidemiological landscape, disease biology, and clinical management.
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