Survival in conventionally treated younger (< 60 years) multiple myeloma patients: no improvement during two decades

The patient registers of five prospective population based Nordic studies w ere reviewed for patients < 60 yr. A total of 313 patients with symptomatic multiple myeloma were identified. Thirty-nine of them were judged retrospe ctively to have been ineligible for intensive chemotherapy regimens. The re maining 274 patients were considered appropriate as a historical control gr oup for comparison with patients treated with high-dose chemotherapy and au tologous stem cell support. Of these, 32 had been diagnosed during the peri od 1970-83, 101 during the period 1984-89 and 141 during the period 1990-92 . The median age was 54 yr. Six percent were Durie/Salmon stage I, 38% stag e II and 56% stage III. Melphalan-prednisone was used for initial therapy i n 87%. Median survival for all patients with symptomatic myeloma was found to be 41 months, and for those selected for the control group 44 months, wi th no noted differences between the aforementioned diagnostic periods. We c onclude that the expected median survival is 44 months for myeloma patients <60 yr who may be considered for high-dose therapy protocols. New developm ents in chemotherapy and supportive therapy, achieved during the two decade s which preceded the use of high-dose chemotherapy with stem cell rescue, h ave not changed the overall prognosis in multiple myeloma.