%0 Journal Article %T Epidemiological landscape of young patients with multiple myeloma diagnosed before 40 years of age: the French experience %+ CHU Amiens-Picardie %+ CHU Limoges %+ CHU Bordeaux [Bordeaux] %+ Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037) %+ Service hématologie Nice %+ Département de Médecine Nucléaire [CHU Nantes] %+ Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma (CRCINA-ÉQUIPE 10) %+ Service d'Hématologie [Nantes] %+ Site de Recherche Intégrée sur le Cancer [Nantes] (SIRIC) %+ Imaging and Longitudinal Investigations to Ameliorate Decision-making [Nantes] (ILIAD) %+ Centre Hospitalier Universitaire [Grenoble] (CHU) %+ CHU Dijon %+ Service d'Immunopathologie [Hôpital Saint-Louis, Paris] %+ Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel) %+ Pathologie cellulaire : aspects moléculaires et viraux / Pathologie et Virologie Moléculaire %+ Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon) %+ Service d’Hématologie [Institut Paoli Calmettes, Marseille] %+ Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille) %+ CHU Saint-Antoine [AP-HP] %+ Centre hospitalier universitaire de Poitiers (CHU Poitiers) %+ HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666 (HEMATIM) %+ Hopital Saint-Louis [AP-HP] (AP-HP) %A Caulier, Alexis %A Roussel, Murielle %A Morel, Pierre %A Lombion, Naelle %A Branco, Benoit %A Galtier, Jean %A Hulin, Cyrille %A Perrot, Aurore %A Richez, Valentine %A Michaud, Anne-Victoire %A Touzeau, Cyrille %A Doyen, Chantal %A Mariette, Clara %A Caillot, Denis %A Harel, Stephanie %A Lenain, Pascal %A Ivanoff, Sarah %A Fontan, Jean %A Stoppa, Anne-Marie %A Manier, Salomon %A Garderet, Laurent %A Leleu, Xavier %A Marolleau, Jean-Pierre %A Arnulf, Bertrand %A Avet-Loiseau, Herve %A Royer, Bruno %< avec comité de lecture %@ 0006-4971 %J Blood %I American Society of Hematology %V 138 %N 25 %P 2686-2695 %8 2021 %D 2021 %R 10.1182/blood.2021011285 %Z Life Sciences [q-bio]Journal articles %X Multiple myeloma (MM) is rare in young patients, especially before age 40 years at diagnosis, representing <2% of all patients with MM. Little is known about the disease characteristics and prognosis of these patients. In this study, we examined 214 patients diagnosed with MM at age <= 40 years over 15 years, in the era of modern treatments. Among them, 189 patients had symptomatic MM. Disease characteristics were similar to older patients: 35% had anemia, 17% had renal impairment, and 13% had hypercalcemia. The staging was ISS-1 in 52.4%, ISS-2 in 27.5%, and ISS-3 in 20.1%. Overall, 18% of patients had high-risk cytogenetics [del 17p and/or t(4;14)]. Ninety percent of patients received intensive chemotherapy followed by autologous stem cell transplant, and 25% of patients had allogeneic stem cell transplant predominantly at time of relapse. The median follow-up was 76 months, the estimated median overall survival was 14.5 years, and the median progression free-survival was 41 months. In multivariate analysis, bone lesions (hazard ratio [HR], 3.95; P =.01), high ISS score (HR, 2.14; P =.03), and high-risk cytogenetics (HR, 4.54; P <.0001) were significant risk factors for poor outcomes. Among predefined time-dependent covariables, onset of progression (HR, 13.2; P <.0001) significantly shortened overall survival. At 5 years, relative survival compared with same age- and sexmatched individuals was 83.5%, and estimated standardized mortality ratio was 69.9 (95% confidence interval, 52.7-91.1), confirming that MM dramatically shortens the survival of young patients despite an extended survival after diagnosis. %G English %L hal-03578209 %U https://u-picardie.hal.science/hal-03578209 %~ UNIV-NANTES %~ UNIV-TLSE3 %~ CNRS %~ UNIV-PICARDIE %~ UNIV-ANGERS %~ APHP %~ LORIA2 %~ CRCINA %~ SORBONNE-UNIVERSITE %~ SORBONNE-UNIV %~ SU-MEDECINE %~ SU-MED %~ UNIV-PARIS %~ UNIVERSITE-PARIS %~ SU-TI %~ U-PICARDIE %~ HEMATIM %~ ALLIANCE-SU %~ NANTES-UNIVERSITE %~ UNIV-NANTES-AV2022 %~ UNIV-UT3 %~ UT3-INP %~ UT3-TOULOUSEINP