Análise de sobrevida em uma corte de idosos com mieloma múltiplo submetidos a tratamento em um hospital público de referência em oncologia do Distrito Federal

Abstract

Introduction: Multiple myeloma is characterized by the clonal proliferation of malignant plasma cells in the bone marrow, monoclonal protein in the blood or urine, with the occurrence of associated organ dysfunction. Despite being considered rare, it is the 2nd most common hematologic malignancy in the world. Objectives: To perform a survival analysis in elderly patients with multiple myeloma submitted to treatment at a reference hospital in the Federal District. Method: A descriptive survival study was performed in a retrospective cohort of 66 patients with multiple myeloma aged 60 years or older at diagnosis. The Kaplan-Meier method was used with the Log-rank test for univariate survival analysis and Cox regression for multivariate analysis and identification of survival risk through the Hazard function. For all analyses were considered significant value p≤0.05. Results: Most participants had advanced stage disease at diagnosis using the Durie-Salmon staging system (88.1%) and half (50%) had advanced stage disease using the ISS staging system. The median age of the study population was 70.50 years, most patients were male (53%), brown (48.8%), married (42.6%), had completed elementary school (42.9%) and retired (68.1%). The 5- year survival was 67.3%, with an overall survival of 78.85 months. The IgM monoclonal type at diagnosis indicated worse survival and IgG and IgA better survival. Hemoglobin less than 8.5 mg/dL (HR:3.193, 95%CI:1.115-9.146, p=0.035), platelets below 150,000/ μl (HR:5.002, 95%CI:1.778-14.070, p=0.002) and albumin less than 3.5 g/dL (HR:5.665, 95%CI:1.523-21.049, p=0.010) directly affected survival and risk of death, with a significant association between platelets and albumin. Conclusions: Multiple myeloma is a rare disease with a relatively small number of published studies when compared to other neoplasms. In this study, patients with severe anemia, thrombocytopenia, abnormal albumin levels, and IgM monoclonal type at diagnosis had a worse prognosis. For this population, the variables platelets and albumin were predictors of survival.