The results of therapy of patients with multiple myeloma in real clinical practice (results of a multicenter study)

Abstract

Introduction. Multiple myeloma (MM) accounts for 1% of all cancers and about 10% of all hematological malignancies. Although there are many types of current therapeutic approaches, MM still remains an incurable disease, which points to the need for improvement of the management of patients with this disease in real-world clinical settings.Aim. To analyze the actual practice of treating Russian patients with multiple myeloma (MM).Materials and methods. A multicenter observational retrospective study was conducted. The final analysis included data from 268 patients with the diagnosis code C 90.0, C90.1, C 90.2, C 90.3 ICD-10, aged ≥ 18 years, treated and monitored in 3 Russian centers.Results. 31.7% of patients had bone and/or extramedullary plasmacytomas. According to Durie Salmon, there were patients with stage III (56.1%) prevailed in ISS - with stage II (41.8%). Cytogenetic studies were performed only in 5.2% of patients. Patients most often encountered diseases of the cardiovascular system (43.3%), kidneys (14.7%), endocrine system (13.1%). The average number of days of hospitalization is about 41.9 days per calendar year. In the first line, 90% of patients received bortezomib-based regimens, 15.8% received high-dose chemotherapy with autologous hematopoietic stem cell transplantation. 66.7% of first-line patients responded to treatment. In the 2nd line, the most commonly prescribed regimen was Rd (lenalidomide with dexamethasone (26.83%), bortezomib-based regimens (24.39%), regimens with the inclusion of new agents (daratumumab, ixazomib, carfilzomib) (17.07%) 40.82% patients responded to treatment.Three-line regimens were dominated by chemotherapy (29.73%) and with the inclusion of new agents (daratumumab, pomalidomide, carfilzomib) (27.03%), 39.3% responded to treatment.Conclusion. Optimization of therapy for patients with MM and the need to improve approaches to the treatment of this disease remains a significant problem in the modern healthcare system. The results of the management and treatment of patients in real practice is of decisive importance for the choice of the most effective methods of therapy.