Characterization and Comparative Outcomes of Younger Multiple Myeloma Patients

• Published in: Blood 2024-11, Vol.144 (Supplement 1), p.5155-5155
• Main Authors: Tufano-Sugarman, Andrea, Islam, Shahidul, Davies, Faith E, Morgan, Gareth, Kaminetzky, David, Lahoud, Oscar B, Braunstein, Marc J
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2024-211737

Introduction: With a median age at diagnosis of 69, multiple myeloma (MM) tends to impact older individuals. Patients younger than 50 years represent only 10% of diagnoses and are less well characterized. Some studies have suggested that younger MM patients are more likely to present with lytic lesions, express uncommon isotypes, have higher-risk cytogenetics, and have relatively improved survival. We aimed to characterize this understudied population in the modern era, and compare them to an older cohort age 50 or greater. Methods: Using our institution's data registry to identify all patients meeting IMWG criteria for MM across our cancer center network between 2010 and 2023, patients less than age 50 (cohort A) were compared to controls age 50 or greater (cohort B) using a 2:1 matching strategy based on three grouped demographic variables: gender, year of diagnosis, and race. Demographics, symptoms, lab values at presentation, cytogenetics, and treatment data were collected. Survival was measured as months from diagnosis to last follow-up or death. Results: We identified 106 patients in cohort A, with a median age of 44 (range 26-49), and 206 matched controls age 50 or greater in cohort B, with a median age of 68 (range 50-92). Male to female ratio was slightly more skewed in cohort B (46 and 54%) compared to cohort A (49 and 51%). The racial breakdown for cohort A was 21.7% white, 34% black, 27% Hispanic, 10% Asian, and 12% other. This was similar in cohort B due to race matching. The most common isotype in both cohorts was IgG (57.6% in A; 48% in B), however 19% of cohort A had light chain-only disease, compared to 16% of cohort B (P 25 (overweight), and 32% had BMI > 30, (obese), compared with cohort B in which BMIs were 69% BMI >25 and 28% BMI >30. With regard to presentation, in cohort A, incidentally found cases, defined as abnormalities on imaging or labs ordered for another reason, represented 7% of cases, whereas 77% had at least one CRAB symptom at diagnosis. Significant differences included: 32% of cohort A presented with significant anemia (hemoglobin 2 mg/dL) compared to 12% of cohort B. 1