MULTIPLE-MYELOMA IN YOUNG-PATIENTS - CLINICAL PRESENTATION AND TREATMENT APPROACH

Multiple myeloma (MM) in patients younger than 40 or 30 years accounts for only 2% and 0.3% of all myelomas, respectively. The presenting cl inical and laboratory features are similar to those observed in patien ts of all ages who have myeloma, except a higher proportion of young p atients have only light-chain myeloma. Some very young patients, parti cularly those younger than 30 years, have multiple skeletal lesions wi th extramedullary spread and a small M-component with few bone marrow plasma cells. In young patients with MM, particularly in those with go od prognostic features (that is, normal renal function or low beta(2)- microglobulin level) and also in those younger than 30 years, the surv ival is longer than that in series of patients of all ages with MM. Yo ung patients with MM might benefit from early high-dose therapy follow ed by autologous or allogeneic stem cell rescue. The current status of autologous and allogeneic transplantation in MM is reviewed.