TY - JOUR
T1 - Improved survival in myeloma patients- a nationwide registry study of 4647 patients ≥75 years treated in Denmark and Sweden
AU - Moore, Kari Lenita Falck
AU - Turesson, Ingemar
AU - Genell, Anna
AU - Klausen, Tobias W
AU - Knut-Bojanowska, Dorota
AU - Redder, Louise
AU - Sverrisdottir, Ingigerdur
AU - Thorsen, Jonathan
AU - Vangsted, Annette J
AU - Blimark, Cecilie H
PY - 2023/6/1
Y1 - 2023/6/1
N2 - The prevalence of multiple myeloma (MM) is increasing in Nordic countries and the rest of the western world. Patients aged ≥75 years at diagnosis constitute an increasing proportion of all MM patients, but are underrepresented in randomized clinical trials. There is an urgent need for studies of the characteristics, treatment and outcome in this cohort. We present data from two nationwide population-based registries of all MM patients diagnosed in Denmark from January 1, 2005 until February 18, 2020, and in Sweden from January 1, 2008 until December 31, 2019, including treatment data for patients diagnosed until 2018 (Denmark) and 2019 (Sweden). In total 4,647 patients were ≥75 years at diagnosis, compared to 7,378 younger patients. Patients ≥75 years, accounting for approximately 40% of all MM patients, are a distinct cohort with more advanced disease at diagnosis, reflected by higher International Staging System (ISS) stage, and a higher proportion have renal failure and anemia. We found a more gradual introduction of modern medications in the older cohort than in the younger, despite simultaneous changes in guidelines. Compared to the cohorts in randomized controlled trials that guide the treatment of non-transplant eligible patients, we found a higher proportion of patients ≥75 years and presenting with ISS III in the real-world populations. Nevertheless, response rates and survival are increasing, indicating that modern treatment regimens are effective and well tolerated also in elderly MM patients in real-world populations.
AB - The prevalence of multiple myeloma (MM) is increasing in Nordic countries and the rest of the western world. Patients aged ≥75 years at diagnosis constitute an increasing proportion of all MM patients, but are underrepresented in randomized clinical trials. There is an urgent need for studies of the characteristics, treatment and outcome in this cohort. We present data from two nationwide population-based registries of all MM patients diagnosed in Denmark from January 1, 2005 until February 18, 2020, and in Sweden from January 1, 2008 until December 31, 2019, including treatment data for patients diagnosed until 2018 (Denmark) and 2019 (Sweden). In total 4,647 patients were ≥75 years at diagnosis, compared to 7,378 younger patients. Patients ≥75 years, accounting for approximately 40% of all MM patients, are a distinct cohort with more advanced disease at diagnosis, reflected by higher International Staging System (ISS) stage, and a higher proportion have renal failure and anemia. We found a more gradual introduction of modern medications in the older cohort than in the younger, despite simultaneous changes in guidelines. Compared to the cohorts in randomized controlled trials that guide the treatment of non-transplant eligible patients, we found a higher proportion of patients ≥75 years and presenting with ISS III in the real-world populations. Nevertheless, response rates and survival are increasing, indicating that modern treatment regimens are effective and well tolerated also in elderly MM patients in real-world populations.
KW - Aged
KW - Denmark/epidemiology
KW - Humans
KW - Multiple Myeloma/diagnosis
KW - Prevalence
KW - Registries
KW - Sweden/epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85160966569&partnerID=8YFLogxK
U2 - 10.3324/haematol.2021.280424
DO - 10.3324/haematol.2021.280424
M3 - Journal article
C2 - 36300775
SN - 0390-6078
VL - 108
SP - 1640
EP - 1651
JO - Haematologica
JF - Haematologica
IS - 6
ER -