@article{Sara Bringhen_Maria Victoria Mateos_Sonja Zweegman_Alessandra Larocca_Antonietta Pia Falcone_Albert Oriol_Davide Rossi_Maide Cavalli_Pierre Wijermans_Roberto Ria_Massimo Offidani_Juan Jose Lahuerta_Anna Marina Liberati_Roberto Mina_Vincenzo Callea_Martijn Schaafsma_Chiara Cerrato_Roberto Marasca_Luca Franceschini_Andrea Evangelista_Ana-Isabel Teruel_Bronno van der Holt_Vittorio Montefusco_Giovannino Ciccone_Mario Boccadoro_Jesus San Miguel_Pieter Sonneveld_Antonio Palumbo_2013, place={Pavia, Italy}, title={Age and organ damage correlate with poor survival in myeloma patients: meta-analysis of 1435 individual patient data from 4 randomized trials}, volume={98}, url={https://haematologica.org/article/view/6701}, DOI={10.3324/haematol.2012.075051}, abstractNote={Thalidomide and bortezomib are extensively used to treat elderly myeloma patients. In these patients, treatment-related side effects are frequent and full drug doses difficult to tolerate. We retrospectively analyzed data from 1435 elderly patients enrolled in 4 European phase III trials including thalidomide and/or bortezomib. After a median follow up of 33 months (95%CI: 10–56 months), 513 of 1435 patients (36%) died; median overall survival was 50 months (95%CI: 46–60 months). The risk of death was increased in patients aged 75 years or over (HR 1.44, 95%CI: 1.20–1.72; <em>P</em><0.001), in patients with renal failure (HR 2.02, 95%CI: 1.51–2.70; <em>P</em><0.001), in those who experienced grade 3–4 infections, cardiac or gastrointestinal adverse events during treatment (HR 2.53, 95%CI: 1.75–3.64; <em>P</em><0.001) and in those who required drug discontinuation due to adverse events (HR 1.67, 95%CI; 1.12–2.51; <em>P</em&gt;=0.01). This increased risk was restricted to the first six months after occurrence of adverse events or drug discontinuation and declined over time. More intensive approaches, such as the combination of bortezomib-thalidomide, negatively affected outcome. Bortezomib-based combinations may overcome the negative impact of renal failure. Age 75 years or over or renal failure at presentation, occurrence of infections, cardiac or gastrointestinal adverse events negatively affected survival. A detailed geriatric assessment, organ evaluation and less intense individualized approaches are suggested in elderly unfit subjects.}, number={6}, journal={Haematologica}, author={Sara Bringhen and Maria Victoria Mateos and Sonja Zweegman and Alessandra Larocca and Antonietta Pia Falcone and Albert Oriol and Davide Rossi and Maide Cavalli and Pierre Wijermans and Roberto Ria and Massimo Offidani and Juan Jose Lahuerta and Anna Marina Liberati and Roberto Mina and Vincenzo Callea and Martijn Schaafsma and Chiara Cerrato and Roberto Marasca and Luca Franceschini and Andrea Evangelista and Ana-Isabel Teruel and Bronno van der Holt and Vittorio Montefusco and Giovannino Ciccone and Mario Boccadoro and Jesus San Miguel and Pieter Sonneveld and Antonio Palumbo}, year={2013}, month={May}, pages={980-987} }