Age-centric insights: A single-center analysis of clinical presentation, treatment approaches, and outcomes in multiple myeloma patients across different age groups.

Abstract

e19532 Background: Multiple myeloma (MM) accounts for approximately 10% of hematologic malignancies, with a rising incidence in low- and middle-income countries. Age significantly influences disease biology, treatment patterns, and prognosis; however, regional data from South Asia remain limited. Methods: We conducted a retrospective observational cohort study of MM patients diagnosed between December 2010 and March 2023. A total of 218 patients were included using non-probability consecutive sampling and were stratified into three age groups: 30–50 years (n = 44), 51–71 years (n = 140), and >72 years (n = 34). Data were extracted from the Health Information Management System (HIMS). Statistical analyses included Chi-square testing, analysis of variance (ANOVA), and Kaplan–Meier survival analysis using Microsoft Excel 365 and GraphPad Prism version 10.2.3. A p-value <0.05 was considered statistically significant. Results: Male predominance was observed across all age groups. The majority of patients presented with advanced disease (R-ISS II/III: 59.1%, 88.6%, and 94.1% in Groups 1, 2, and 3, respectively). CRAB features varied by age: younger patients more frequently exhibited anemia and renal impairment, whereas older patients had higher rates of hypercalcemia and pathological fractures. CYBORD was the most commonly used induction regimen, while <10% underwent autologous stem-cell transplantation due to financial and logistical constraints. Partial response was the most frequent outcome across all groups (55–64%), with complete/stringent complete responses achieved in only 11–19%. On multivariate analysis, elevated β2-microglobulin, higher bone marrow plasma cell infiltration, creatinine, and absolute neutrophil count predicted inferior survival, while higher serum albumin was protective. Median overall survival was lowest in the youngest cohort (45 months vs. 60–70 months in older groups). Conclusions: In this South Asian cohort, younger MM patients exhibited more aggressive disease biology and inferior survival despite greater physiological reserve, whereas older patients demonstrated higher cytopenias but lower marrow involvement. Limited access to transplantation and novel therapies further constrained outcomes, underscoring the need for age-adapted strategies and improved resource allocation.