Multiple myeloma; Older adults; Prognostic factorsHEMATOPOIETIC-CELL TRANSPLANTATION; INTERNATIONAL STAGING SYSTEM; MYELOMA PATIENTS; ELDERLY-PATIENTS; GERIATRIC ASSESSMENT; COMORBIDITY INDEX; 1ST TRIAL; SURVIVAL; AGE; VALIDATION

The main goal was to find a simple prognostic to evaluate overall survival of patients older than 65years of age with myeloma. Retrospective registry-based analysis from the Registry of Monoclonal Gammopathies was conducted. Patients over 65years with symptomatic myeloma were included. The four major parameters with impact on survival were identified: male gender, age>75, creatinine >152mol/L, and ECOG performance status 2-4. The patients were scored as good (0 points), intermediate good (1 point), intermediate poor (2 points), poor (3-4 points). Patients (1410 MM) were included. Median OS (months) was 65.7 (95% CI 49.8-81.7) for good, 51.0 (44.1-57.8) for intermediate good, 32.2 (26.2-38.2) for intermediate poor, and 18.9 (15.1-22.7) for poor. The differences in OS were statistically significant (p<0.0001). Good score was used as reference for hazard ratios, which for each other score were 1.43 (1.09-1.84) for intermediate good, 2.58 (2.00-3.33) for intermediate poor, and 3.88 (2.94-5.10) for poor. Time to progression showed medians (months) 20.5 (17.4-62.4) for good, 19.3 (17.0-21.7) for intermediate good, 19.6 (16.2-23.0) for intermediate poor, and 13.0 (10.8-15.2) for poor. The suggested scoring system provides readily available information about the prognosis of MM patients above 65years.