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closeMultiple Myeloma in young man
Posted by faguet on 22 Mar 2014 at 19:58 GMT
According to Ludwig H, Durie GM, Bolejack V, et al (Blood April 15, 2008 vol. 111 no. 8 4039-4047), “Median age of all 10,549 [Multiple Myeloma] patients combined was 60 years. Of these, 1,689 (16%) patients were younger than 50 years. Of those,...82% were between 40…[and] 50 years of age. Only 312 patients were younger than 40 years, and 27 patients were younger than 30 years. Median age of the 8,860 patients 50 years or older was 62 years (range, 50-93 years), and the median age of the 1,689 patients less than age 50 years was 36 years (range, 20-49 years).”
Based on that large patient population and from a purely statistical point of view, Multiple Myeloma in patients 25-35 years of age represent 0.25% +/- of the total Multiple Myeloma patient population today and was unlikely higher 32 centuries ago. Hence, while entirely possible it is unlikely that skeleton 244-B exhibited Multiple Myeloma, which makes the 2,700-year-old Scythian King from Arzhan (Siberia, Russia) - your reference 96 - the oldest human credibly proven to have exhibited metastatic cancer.
Guy B. Faguet, M.D.
Professor of Medicine (Hematology/Oncology) - Retired
Georgia Regents University
Augusta, GA - USA
RE: Multiple Myeloma in young man
michaela_binder replied to faguet on 27 Mar 2014 at 21:08 GMT
Dear Prof. Faguet,
Thank you very much for your thoughts on our study. As is clearly stated in the paper, we agree with your opinion and do not think that the person suffered from multiple myeloma. Evidence for new bone formation associated with the lesions in skeleton 244-8 make a diagnosis of highly multiple myeloma unlikely but rather argues for metastatic carcinoma. The person is certainly young according to modern standards. However it is difficult to translate modern clinical statistics to populations in the past because exposure to risk factors may have differed. Moreover, we don't yet know anything about the genetic background of these people. If environmental conditions such as indoor pollution or schistosomiasis were to be blamed for the carcinoma in this person, pressumably he would been exposed from a very early age onwards which may have led to cancer at this early age.
Best regards,
Michaela Binder