Hi, I'm Dr. Marc Braunstein. I'm a hematology cytologist at the NYU Perlmutter Cancer Center in New York. This year, we're presenting a poster on comparative outcomes of younger multiple myeloma patients under age 50 compared to older patients. Patients under 50 with multiple myeloma represent only about 10% of all myeloma patients, so they're less well characterized.
In collaboration with the HealthTree Cure database, we aimed to characterize younger patients compared to older multiple myeloma patients who have a median diagnosis age of 69.
In our study, we found that younger patients were more likely to undergo autologous stem cell transplant, with about 75% of the patients in our study. They were also more likely to present with skeletal or lytic lesions. Their outcomes were impressive, with a median four-year survival rate upwards of 98% in our study, which spanned from 2010 to 2023. There was a mix of triplet and quadruple regimens, but overall, survival was very impressive.
We have to understand that multiple myeloma is a diverse disease and can affect younger patients as well. These patients need the same care as our older patients to manage treatment and support issues that may not be the same for older patients, such as preserving fertility.
I think the implications of the study are helpful, not only in characterizing their outcomes but also in shedding light on the fact that younger patients with this disease have special needs to manage their disease at their age group.
One reason why younger multiple myeloma patients may feel better is because they have fewer medical conditions, better-preserved organ function, and more bone marrow reserves. One implication is that we should be aggressive in treating younger multiple myeloma patients to prolong their lifespan as much as possible, especially in high-risk patients. Our study only included about 20% high-risk patients, which is on par with the typical incidence of high-risk myeloma. But for standard-risk patients who are younger and newly diagnosed with multiple myeloma, we should be as aggressive as possible to prolong survival.
I think whether we're talking about younger patients or comparing them to older patients over the age of 60, it's important to be aware that this disease is characterized by major differences between individuals, both in terms of their myeloma genetic profile and how they present symptoms. It's really important to see a myeloma specialist who can break down the important characteristics of your individual disease and create a treatment plan tailored for you.
One thing in our study, since it spanned more than a decade, is that only about 30% of the patients in our group received quadruplet regimens. At the current state of affairs, all patients who are fit should receive a quadruplet regimen. There's plenty of data being presented at the current ASH meeting, both for transplant-eligible and transplant-ineligible, newly diagnosed patients, that shows quadruplet regimens do better than triplets. I think that's one of the major implications.
HealthTree • December 13, 2024