Chapter 4 – Treatment of elderly patients with myeloma

Contributors: Eileen M Boyle, Charline Legrand, Hélène Demarquette, Stéphanie Guidez, Charles Herbaux, Xavier Leleu, and Thierry Facon

2 – Epidemiology

Myeloma represents 2% of all malignant diseases, with an incidence of 9.3/100,000 per year accounting for approximately 5500 new cases each year in the UK (representing roughly 2900 deaths per year) [4,6]. The median age at diagnosis is 69 years, but 24.1% of patients are diagnosed after 75, and 9.2% after 85 [1]. This is likely to increase in the years to come especially in Europe where it is foreseen that the percentage of Europeans aged over 65 will increase from 18% of the population in 2013 to 28% of the population in 2060 [5]. Population-based US studies suggest that the 5-year relative survival is 30.3% for patients with multiple myeloma (MM) aged over 75 years, which is under half of that of patients aged under 65 years (62.4%), suggesting that progress still needs to be made for these patients [1]. The UK population data are largely consistent with this, with a five-year net survival of 25% for those aged 80–99 years at diagnosis and 44% for those aged 70–79 years at diagnosis [4,6].