Multiple Myeloma Presenting in Patients Younger than 50 Years of Age: A Single Institution Experience

Abstract

<b><i>Introduction:</i></b> Multiple myeloma (MM) is uncommon in persons younger than 50 years of age. The presenting features in this age group are unclear. <b><i>Methods:</i></b> We analyzed a cohort of patients &#x3c;50 years of age with MM treated in our center. <b><i>Results:</i></b> Twenty-three patients at a median age of 41.5 years (range 27–49) were analyzed. Patients presented at International Staging System (ISS) I–II (79%), had high frequency of bone lytic lesions (89%), extramedullary disease (26%), light-chain myeloma (45%), and translocation <i>t</i>(11;14) (68%). The subpopulation of patients carrying <i>t</i>(11;14) were younger (<i>p</i> = 0.025). This subgroup had higher bone marrow infiltration of plasma cells (75 vs. 47.5%), higher incidence of proteinuria (2.9 vs. 0.19 g/day), and poorer response to therapy: 85.7% of patients achieving complete/very good partial remission after induction therapy did not have <i>t</i>(11;14). A trend toward inferior progression-free survival (PFS) was observed in patients with <i>t</i>(11; 14) compared to patients without this translocation (median PFS 18 and 36 months, respectively). <b><i>Discussion/Conclusion:</i></b> Translocation <i>t</i>(11; 14) seems to be more prevalent in young myeloma patients. Young myeloma patients and especially those who harbor translocation <i>t</i>(11; 14) may represent a distinct clinical entity that confers a poor outcome.