Life Expectancy for Multiple Myeloma
The current median survival for patients with newly diagnosed multiple myeloma is approximately 5-7 years, with the 5-year relative survival rate now reaching 58% (2011-2017 data), representing a dramatic improvement from 25% in 1975. 1
Overall Survival by Age
Survival decreases steadily with advancing age:
- Patients <50 years: median survival of 6.4 years 2
- Patients 50-59 years: progressively shorter survival 2
- Patients 60-69 years: further decline in survival 2
- Patients 70-79 years: median survival continues to decrease 2
- Patients ≥80 years: median survival of 2.5 years 2
The mean observed survival across all age groups is 3.7 years, though this includes patients from earlier treatment eras. 2
Risk-Stratified Prognosis
Standard-risk patients can expect 7-10 years of survival with good quality of life, while high-risk patients have significantly shorter survival. 1
The International Staging System (ISS) is the primary staging tool:
- ISS Stage I: Best prognosis (β2-microglobulin <3.5 mg/L and albumin ≥3.5 g/dL) 3
- ISS Stage II: Intermediate prognosis 3
- ISS Stage III: Poorest prognosis (β2-microglobulin ≥5.5 mg/L) 3
High-risk cytogenetic abnormalities significantly worsen prognosis:
- del(13q), t(4;14), t(14;16), and del(17p) detected by FISH or conventional karyotyping are associated with poorer outcomes 3
- These features should be assessed at diagnosis to guide treatment intensity 3
Specific Age-Related Survival Data
For elderly patients (≥65 years) treated with modern regimens:
- 3-year overall survival rate: 68.5% with melphalan/prednisone/bortezomib 4
- Median overall survival: 40 months (3.3 years) with melphalan/prednisone/thalidomide versus 31 months with older regimens 4
- For patients aged 74 years specifically: median survival of approximately 3-4 years with standard treatment, though this varies significantly based on ISS stage, cytogenetics, and treatment response 4
Years of Life Lost
The average years of life lost per patient is 16.8 years across all ages, but varies dramatically by age at diagnosis:
- Patients <40 years: 36.1 years of life lost 2
- Patients 40-49 years: progressively fewer years lost 2
- Patients ≥80 years: 4.6 years of life lost 2
This represents a higher burden of years of life lost compared to many other cancers. 2
Racial Disparities in Survival
African American patients have complex survival patterns:
- When receiving equal access to modern therapies, African American patients may have equal or superior survival compared to White patients (median 64.6 months vs 54.5 months in one real-world analysis) 3
- The 5-year relative survival improved from 29% (1975-1977) to 58% (2011-2017) among Black patients versus 24% to 55% among White patients 3
- However, African American patients experience poor access to care, treatment delays, and underutilization of effective therapies, which negatively impacts outcomes despite potentially favorable disease biology 3
Critical Caveats
Multiple myeloma remains incurable for the vast majority of patients, with nearly all experiencing disease relapse. 1
Most patients receive four or more different lines of therapy throughout their disease course, reflecting the chronic relapsing nature of the disease. 1
Long-term survivors (≥10 years) exist but represent only 2.9% of patients treated with conventional chemotherapy, typically characterized by age ≤65 years, response to first-line therapy, absence of Bence-Jones proteinuria, and prolonged duration of response. 5
Young patients (<30 years) may have better outcomes, with median overall survival of 166 months (13.8 years) and 5-year survival of 77%, particularly when treated with novel agents and autologous stem cell transplantation. 6