Canterbury DHB

Context

Prognosis, Risk Factors and the Decision to Treat

When treated using standard chemotherapy and autografts, myeloma has a median survival of about 4 years. The use of newer drugs such as thalidomide, bortezomib and lenalidomide has probably increased the median survival but still does not cure the disease.

Opinions differ as to whether allogeneic transplant offers a cure for myeloma, but long term disease-free complete molecular remissions are well documented using this approach.

There are many identified markers that can predict for poor prognosis. One of the most simple, powerful and clinically relevant is from Greipp et al – the International Staging System for myeloma:

STAGE

B-2-microglobulin

Albumin

Median Survival(months)

1

<3.5 mg/l

>35 g/l

62

11

Neither stage 1 nor stage 111

45

111

>5.5 mg/l

Any

29

Renal failure at presentation carries with it a median survival of 8 months.

About this Canterbury DHB document (5584):

Document Owner:

Sean Macpherson (see Who's Who)

Issue Date:

September 2014

Next Review:

September 2016

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5584