Prognostic Factors in Elderly Patients with Multiple Myeloma Treatedwith Weekly Bortezomib

Abstract

Introduction and objectives: The incidence of multiple myeloma (MM) increases with age. There is a clear decrease in overall survival (OS) in older patients. The purpose of this study was to investigate prognostic factors of MM in this population. Materials and methods: This is an analytic prospective single-center study conducted over 27 months including MM elderly patients treated with weekly subcutaneous bortezomib alone or associated with another chemotherapy. Results: Our work has included 45 patients (median age 84.3 years). Most of them (77.7%) had a PS ≥ 2, 75.6% were undernourished and 57, 1% had a Mini Mental State Examination (MMSE)<26. Haematological grade 3 toxicities were observed in 11% of patients. After 17 months mean follow-up, the median of OS was 18.6 months. In univariate analysis, significant predictors for OS were instrumental activities of daily living (IADL) ≥ 2 (p = 0.003), activities of daily living (ADL)<5 (p = 0.005), the body mass index (BMI)<21 (p = 0.03) and using hospitalization at home unit for bortezomib injections (p = 0.01). In multivariate analysis, significant predictors for OS were ADL<5 (p = 0.005), using hospitalization at home unit (p = 0.007) and IADL ≥ 2 (p = 0.05) Conclusion: In our work, weekly subcutaneous bortezomib was well tolerated. We have shown that functional decline, malnutrition and hospitalization at home unit are predictors of OS. These results lead us to reflect on the need to include these factors in the choice of treatment in elderly patients with MM.