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Abstract
The prognosis of multiple myeloma (MM) has improved with the introduction of novel agents. These data are largely derived from clinical trials and might not reflect real-world patient outcomes accurately. We surveyed real-world data from 284 patients newly diagnosed with MM between 2010 and 2018 in Miyazaki Prefecture. The median follow-up period was 32.8 months. The median age at diagnosis was 71 years, with 68% of patients aged >65 years. The International Staging System (ISS) stage at diagnosis was I in 18.4% of patients, II in 34.1%, and III in 47.5%. Bortezomib-containing regimens were preferred as initial treatment; they were used in 147 patients (51.8%). In total, 80% of patients were treated with one or more novel agents (thalidomide, lenalidomide, or bortezomib). Among 228 patients who were treated with novel agents as an initial treatment, the overall response rate (partial response (PR) or better) to initial treatment was 78.4%, and the median time to next treatment (TTNT) was 11.6 months. In the multivariate analysis, PR or better responses to initial treatment were independently favorable prognostic factors for TTNT. The median survival time after initial therapy for patients with novel agents was 56.4 months and 3-year overall survival (OS) was 70.4%. In multivariate analysis, ISS stage I/II disease and PR or better response to initial treatment, and autologous stem cell transplantation (ASCT) were identified as independent prognostic factors for overall survival (OS).
Highlights
Multiple myeloma (MM) is a disease characterized by the proliferation of malignant plasma cells
The median age at diagnosis of our patients was 71 years, and 68% of patients in this study were aged >65 years. These results were similar to those in previous realworld reports from a European multicenter observational study and a Japanese regional study [3,4], but the median age of our patients was approximately 5 years older than in previous reports from the Mayo Clinic, a Japanese Society of Myeloma (JSM) multicenter study, and Czech registry data [2,5,6]
This proportion was similar to the proportion in the European observational study (16%), but was much lower than that in reports from the Mayo Clinic (30%), JSM multicenter study (26.5%), and Czech registry data (31.9%) [2,4,5,6]
Summary
Multiple myeloma (MM) is a disease characterized by the proliferation of malignant plasma cells. The prognosis of patients with MM has improved during the past two decades [2]. The introduction of “novel agents” such as thalidomide, lenalidomide, and bortezomib as well as autologous stem cell transplantation (ASCT) has contributed to this improvement, but MM remains incurable with current therapy. Data demonstrating improvement in MM outcomes are largely derived from clinical trials and might not reflect “real-world” patient outcomes accurately. Several studies based on real-world data have been reported, which are useful for selecting and optimizing treatment in clinical practice [2,3,4,5,6,7,8,9,10]. Studies based on real-world data may be divided into two groups: studies at tertiary referral centers and population-based studies. We conducted a chart review in order to survey the clinical features, therapy options, and outcomes of newly diagnosed MM between 2010 and 2018 in Miyazaki Prefecture, Japan
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