Adrian Duek1,2,3, Luba Trakhtenbrot1,2, Abraham Avigdor1,2, Arnon Nagler1,2, Merav Leiba4,5,6. 1. Division of Hematology and Bone Marrow Transplantation, and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Division of Hematology, Assuta Ashdod University Hospital, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. 4. Division of Hematology and Bone Marrow Transplantation, and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel, meravlei@assuta.co.il. 5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, meravlei@assuta.co.il. 6. Division of Hematology, Assuta Ashdod University Hospital, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel, meravlei@assuta.co.il.
Abstract
INTRODUCTION: Multiple myeloma (MM) is uncommon in persons younger than 50 years of age. The presenting features in this age group are unclear. METHODS: We analyzed a cohort of patients <50 years of age with MM treated in our center. RESULTS: Twenty-three patients at a median age of 41.5 years (range 27-49) were analyzed. Patients presented at International Staging System (ISS) I-II (79%), had high frequency of bone lytic lesions (89%), extramedullary disease (26%), light-chain myeloma (45%), and translocation t(11;14) (68%). The subpopulation of patients carrying t(11;14) were younger (p = 0.025). This subgroup had higher bone marrow infiltration of plasma cells (75 vs. 47.5%), higher incidence of proteinuria (2.9 vs. 0.19 g/day), and poorer response to therapy: 85.7% of patients achieving complete/very good partial remission after induction therapy did not have t(11;14). A trend toward inferior progression-free survival (PFS) was observed in patients with t(11; 14) compared to patients without this translocation (median PFS 18 and 36 months, respectively). DISCUSSION/ CONCLUSION: Translocation t(11; 14) seems to be more prevalent in young myeloma patients. Young myeloma patients and especially those who harbor translocation t(11; 14) may represent a distinct clinical entity that confers a poor outcome.
INTRODUCTION: Multiple myeloma (MM) is uncommon in persons younger than 50 years of age. The presenting features in this age group are unclear. METHODS: We analyzed a cohort of patients <50 years of age with MM treated in our center. RESULTS: Twenty-three patients at a median age of 41.5 years (range 27-49) were analyzed. Patients presented at International Staging System (ISS) I-II (79%), had high frequency of bone lytic lesions (89%), extramedullary disease (26%), light-chain myeloma (45%), and translocation t(11;14) (68%). The subpopulation of patients carrying t(11;14) were younger (p = 0.025). This subgroup had higher bone marrow infiltration of plasma cells (75 vs. 47.5%), higher incidence of proteinuria (2.9 vs. 0.19 g/day), and poorer response to therapy: 85.7% of patients achieving complete/very good partial remission after induction therapy did not have t(11;14). A trend toward inferior progression-free survival (PFS) was observed in patients with t(11; 14) compared to patients without this translocation (median PFS 18 and 36 months, respectively). DISCUSSION/ CONCLUSION: Translocation t(11; 14) seems to be more prevalent in young myelomapatients. Young myelomapatients and especially those who harbor translocation t(11; 14) may represent a distinct clinical entity that confers a poor outcome.