Statistics regarding multiple myeloma (MM) show that the survival rates are lower for older adults. This may stem from a combination of biological factors and limited access to care.

Older adults may also have more co-occurring conditions that affect survival rates and may be more likely to experience more challenges from medication side effects. Additionally, they may be less likely to access certain treatments, such as stem cell transplants.

This article discusses age-related MM prognosis and what the statistics indicate for younger and older adults. It also examines factors that affect older individuals with MM, as well as those that affect people of all ages with the condition.

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The 5-year overall relative survival rate (RSR) is the percentage of people with MM who will be alive 5 years after diagnosis compared to those who do not have MM.

The 5-year overall RSR is 58%. However, it is less favorable in older adults.

While MM has no cure, therapeutic advances have markedly increased the outlook in individuals of all age groups, as detailed below:

Younger people

According to a 2023 study, the 5-year RSR of people ages 15 to 69 improved from 41% between 2001 and 2004 to 69% between 2015 and 2019.

A 2017 review reports that the 10-year RSR among people younger than 65 improved from 19.6% between 1993 and 1997 to 35% between 2003 and 2007.

Older people

The 5-year RSR for people ages 70 to 79 improved from 23% during 2001 to 2004 to 47% during 2015 to 2019.

The 10-year RSR among individuals ages 75 and older improved from 7.8% between 1993 and 1997 to 9.3% between 2015 and 2019.

Learn more about the outlook for people with MM.

Circumstances affecting the outlook in older adults with MM include:

Biological factors

Biological factors refer to a person’s age, sex, or genetics that can influence disease risk.

A 2019 review states that older adults have more age-related health conditions, risks, and functional impairments that can reduce survival. These may include:

Additionally, toxicities that do not pose many difficulties in younger people are more of a challenge for individuals with reduced health.

For instance, older adults have less of a tolerance for opioid pain medication, such as oxycodone (OxyContin, Oxaydo, Oxyfast). In addition, the muscle weakness and mood disturbances associated with corticosteroids, such as prednisone (Deltasone, Prednicot, Rayos), can be particularly debilitating.

Access to care factors

A 2017 study notes that while 10-year RSR has improved in individuals younger than 65 in recent years, it has not improved significantly in those 75 and older. The authors suggest that this may stem from access to care rather than biological factors.

They explain that stem cell transplants are responsible for much of the increase in survival, but this treatment option remains very low in people ages 65 and older. Additionally, survival improvements may be associated with newer medications available through clinical trials that older adults do not enroll in.

Evidence indicates that prolonged use of MM treatment may result in late-occurring side effects and increasing toxicity, some of which can be fatal. Although side effects are more serious in older adults, the increased toxicity that can occur after having certain treatments for a longer period can present health challenges to any person.

In addition, prolonged exposure to certain treatments can increase the risk of secondary primary cancers, which are cancers unrelated to MM. These treatments are:

  • cytostatic therapy — medications that interfere with cell multiplication
  • immunomodulatory therapy — medications that change the immune response

Other factors that affect survival include the stage of MM, which indicates how far the cancer has spread. To illustrate, statistics regarding all ages of people with MM show the 5-year RSR is 79% in the beginning, or localized stage. In contrast, it is 57% after distant spread.

Another factor that affects survival involves complications of MM. For instance, kidney damage can lead to a less favorable outcome. This is one of the most serious and common complications of MM, according to a 2022 review.

Learn more about MM and kidney failure.

Research depicting MM outlook by age indicates that the 5-year RSR is 69% for people ages 15 to 69 and 47% for people ages 70 to 79.

Biological factors that affect the survival of older adults include more age-related chronic health conditions and increased difficulties relating to medication side effects. Additionally, those in this age group may have less access to stem cell transplants and newer treatments from clinical trials.

Factors other than age that influence survival may include the stage and complications of MM, as well as exposure to treatments that increase the risk of secondary primary cancers.