{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:26:56Z","timestamp":1760146016489,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Data on the outcome of octogenarian multiple myeloma (MM) patients (pts), especially if treated outside clinical studies, are scanty. Aims and Methods: MM pts \u2265 80 years, treated at TASMC with first-line therapy between 2010 and 2023, were reviewed. Characteristics and outcomes were analyzed. Results: A total number of 101 pts, of whom 54 were males with a median age of 84 years (80\u201398), were included. Among them, 67.4% had a Charlson comorbidity index of \u22655, 37% had ISS-3 (International staging system) and 20% had Revised-ISS-3. In our study, 44.5% received doublets and 50.5% received triplets\/quadruplets. A bortezomib-based regimen was applied in 87%, and IMiDs were used in 27.7%. Despite an upfront employment of a low lenalidomide dose, dose reductions were required in 48%. Grade \u2265 3 adverse events (AEs) (mainly infections) were documented in 36.6% of patients, including grade 5 events in 9%, all attributed to infections. The overall response rate was 69%, including 31% \u2265 VGPRs (Very good partial response). Sixty-seven percent (67%) received second-line therapy, administered within a median period of 12 months (1\u201384). Within a median follow-up period of 36 m (1\u2013141), the median overall survival (OS) approached 42 m (range: 1\u2013141); being shorter in pts &gt; 84 years (HR = 1.7, p = 0.03), pts with lung disease (HR = 1.8, p = 0.044) and pts with ISS = 3 and R-ISS = 3 (HR = 1.65, p = 0.0016 and HR = 2.45, p = 0.006, respectively); Conclusions: Octogenarians treated outside clinical studies often have a lower tolerance to treatment. Nevertheless, upfront administration of low doses of anti-MM agents provided a response in the majority of patients, translated into impressive OS. Nevertheless, mortality due to AEs was high, emphasizing the need for new, \u201coctogenarian-oriented\u201d treatment protocols.<\/jats:p>","DOI":"10.3390\/cancers16193329","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T05:45:27Z","timestamp":1727675127000},"page":"3329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Outcome of Octogenarian Patients with Multiple Myeloma Treated Outside Clinical Studies, Focusing on Tolerability and Efficacy of Treatment"],"prefix":"10.3390","volume":"16","author":[{"given":"Dana","family":"Amsterdam","sequence":"first","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ori","family":"Grossberger","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natan","family":"Melamed","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4337-1108","authenticated-orcid":false,"given":"Dor","family":"Shpizer","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Trestman","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamir","family":"Shragai","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael C.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irit","family":"Avivi","sequence":"additional","affiliation":[{"name":"Hematology Division, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1002\/ajh.26590","article-title":"Multiple myeloma: 2022 update on diagnosis, risk stratification, and management","volume":"97","author":"Rajkumar","year":"2022","journal-title":"Am. 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Life, 13.","DOI":"10.3390\/life13122259"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/19\/3329\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:06:22Z","timestamp":1760112382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/19\/3329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,29]]},"references-count":29,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["cancers16193329"],"URL":"https:\/\/doi.org\/10.3390\/cancers16193329","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2024,9,29]]}}}