Abstract
BackgroundSome multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors.MethodsThis study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors.ResultsSixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36–37.29). The type of paraprotein at diagnosis (P = 0.026, P = 0.228), International Staging System (ISS) score (P = 0.036, P = 0.067) and autologous stem cell transplant (ASCT) (P = 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression (P = 0.003).ConclusionOur study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.
Highlights
Multiple myeloma (MM) is characterised by clonal proliferation of malignant plasma cells, which can result in an overabundance of monoclonal paraprotein (M-protein), leading to bony lesions, renal injury, hypercalcaemia, cytopenia and increased susceptibility to infections
Most of the recruited patients had IgG paraprotein at diagnosis (60, 68.2%) followed by IgA (19, 21.6%) and free light chain (FLC)-only paraprotein (9, 10.2%); only 1 patient was without a known type of paraprotein at diagnosis
This study found an overall median time to relapse/ progression (TTP) of 29.33 months
Summary
Multiple myeloma (MM) is characterised by clonal proliferation of malignant plasma cells, which can result in an overabundance of monoclonal paraprotein (M-protein), leading to bony lesions, renal injury, hypercalcaemia, cytopenia and increased susceptibility to infections. Before the era of novel agent therapy, MM was regarded as incurable and conventional combination chemotherapy led to a median survival of only three years or less. Some multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/ progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors
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