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. 2025 May;25(5):e310-e318.
doi: 10.1016/j.clml.2024.12.017. Epub 2025 Jan 7.

Disease Characteristics and Treatment Outcomes of Myeloma Patients Under 50 Years of Age: An Analysis of the Balkan Myeloma Study Group

Despina Fotiou  1 , Sorina Nicoleta Badelita  2 , Eirini Katodritou  3 , Meral Beksac  4 , Jelena Bila  5 , Emmanouil Spanoudakis  6 , Josip Batinić  7 , Daniel Coriu  8 , Sinziana Barbu  2 , Catalin Danaila  9 , Dimitra Dalampira  3 , Angeliki Sevastoudi  3 , Guldane Cengiz Seval  10 , Selami Koçak Toprak  10 , Aleksandra Sretenovic  5 , Olivera Markovic  11 , Toni Valkovic  12 , Zorica Cvetkovic  13 , Fenia Theodorakakou  1 , Maria Gavriatopoulou  1 , Evangelos Terpos  1 , Meletios A Dimopoulos  1 , Efstathios Kastritis  14
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Free article

Disease Characteristics and Treatment Outcomes of Myeloma Patients Under 50 Years of Age: An Analysis of the Balkan Myeloma Study Group

Despina Fotiou et al. Clin Lymphoma Myeloma Leuk. 2025 May.
Free article

Abstract

Background: Multiple myeloma (MM) is predominantly a disease of the elderly, but approximately 10% of patients are younger than 50 years at diagnosis. METHODS: This study aimed to investigate the clinical characteristics, treatment outcomes, and prognostic factors in younger MM patients using retrospective data from the Balkan Myeloma Study Group registry. RESULTS: A total of 350 patients under 50 years old were included, comprising 10.4% of the overall cohort. The study found that younger patients had lower rates of renal impairment and anemia but a higher incidence of lytic bone disease and adverse cytogenetics. Treatment regimens, including proteasome inhibitors and immunomodulatory agents, were comparable between younger and older patients, but younger patients had significantly better complete response rates and overall survival (OS). The 5- and 10-year OS rates were 76% and 64%, respectively, with a projected median OS exceeding 15 years. Factors such as anemia, hypercalcemia, and high-risk cytogenetics were associated with worse survival outcomes. Autologous stem cell transplantation (ASCT) emerged as a key contributor to improved progression-free survival (PFS) and OS.

Conclusion: In conclusion, younger MM patients exhibit distinct disease features and benefit from intensified treatment approaches, underscoring the need for tailored therapies to achieve potential disease cure.

Keywords: Balkan Myeloma Study Group; Multiple Myeloma; Overall survival; Prognosis; Young patients with multiple myeloma.

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Conflict of interest statement

Disclosure Kastritis: GSK: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Sanofi: Honoraria. Beksac: Sanofi: Speakers Bureau; Menarini: Membership on an entity's Board of Directors or advisory committees; BMS: Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Speakers Bureau. Katodritou: Janssen Cilag, Amgen, Abbvie, Pfizer, GSK, Takeda, Sanofi, Karyopharm: Honoraria, Research Funding. Dalampira: Pfizer: Research Funding. Coriu: Genesis BioPharma. Gavriatopoulou: Celgene/Genesis: Honoraria; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; GSK: Honoraria; X4 Pharmaceuticals: Research Funding; Karyopharm: Honoraria, Research Funding. Terpos: BMS: Honoraria; Takeda: Honoraria, Other: Travel expenses, Research Funding; Menarini/Stemline: Honoraria; Janssen: Honoraria, Research Funding; GSK: Honoraria, Research Funding; EUSA Pharma: Honoraria, Other: Travel expenses; ASTRA/Zeneca: Honoraria, Other: Travel Expenses; Amgen: Honoraria, Other: Travel Expenses, Research Funding; Pfizer: Honoraria; Sanofi: Honoraria, Other: Travel expenses, Research Funding. Dimopoulos: Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Direc- tors or advisory committees; Regeneron: Honoraria, Membership on an entity's Board of Directors or advisory committees; Menarini: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; GlaxoSmithK- line: Honoraria, Membership on an entity's Board of Directors or advisory committees; BeiGene Inc: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees. Fotiou: Sanofi: Honoraria, Janssen: Honoraria. Batinić: Janssen: Honoraria; Takeda: Honoraria; Amgen: Honoraria. The other authors have no relevant COIs to declare.