open access
Survival in patients with multiple myeloma: a real-life single-center study


- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Garncarska 11, 31-115 Kraków, Poland
- Department of Hematology and Internal Diseases, The Rydygier Hospital., os. Zlotej Jesieni 1, 31-810 Krakow, Poland
- Department and Division of Hematology, Jagiellonian University Medical College, Świętej Anny 12, 31-008 Krakow, Poland
open access
Abstract
Introduction: The development of novel drugs with a different mechanism of action has led to considerable progress in multiple myeloma (MM) treatment. However, the exact associations between overall survival (OS) and different treatment types, response to treatment, as well as clinical and laboratory parameters, have not been fully elucidated. We aimed to determine the effect of clinical and laboratory parameters, type of induction therapy, and high-dose chemotherapy with autologous hematopoietic stem-cell transplant (auto-HSCT) on OS in patients with MM. Material and methods: This retrospective study included 413 patients with MM treated between 2006 to 2017. Correlations between selected clinical and laboratory parameters and OS were assessed. The severity of MM was evaluated using the Durie-Salmon classification. Results: The median OS was 4.08 years. The overall response rate to chemotherapy was 76%. The complete remission (CR) rates were higher in patients receiving bortezomib-based therapy than in those receiving thalidomide-based therapy or standard chemotherapy (p < 0.001). The CR rate was positively correlated with OS. The use of auto-HSCT with bortezomib-based therapy was associated with longer OS. Renal failure and elevated urinary protein levels were inversely correlated with OS. The severity of MM at diagnosis was also associated with OS. The percentage of bone marrow plasma cell infiltration did not correlate with OS. Conclusions: MM is still diagnosed too late, by which time patients have developed almost irreversible complications. However, we confirmed that novel treatments improve OS in these patients, especially when used in addition to auto-HSCT. These findings may facilitate clinical therapeutic decision making.
Abstract
Introduction: The development of novel drugs with a different mechanism of action has led to considerable progress in multiple myeloma (MM) treatment. However, the exact associations between overall survival (OS) and different treatment types, response to treatment, as well as clinical and laboratory parameters, have not been fully elucidated. We aimed to determine the effect of clinical and laboratory parameters, type of induction therapy, and high-dose chemotherapy with autologous hematopoietic stem-cell transplant (auto-HSCT) on OS in patients with MM. Material and methods: This retrospective study included 413 patients with MM treated between 2006 to 2017. Correlations between selected clinical and laboratory parameters and OS were assessed. The severity of MM was evaluated using the Durie-Salmon classification. Results: The median OS was 4.08 years. The overall response rate to chemotherapy was 76%. The complete remission (CR) rates were higher in patients receiving bortezomib-based therapy than in those receiving thalidomide-based therapy or standard chemotherapy (p < 0.001). The CR rate was positively correlated with OS. The use of auto-HSCT with bortezomib-based therapy was associated with longer OS. Renal failure and elevated urinary protein levels were inversely correlated with OS. The severity of MM at diagnosis was also associated with OS. The percentage of bone marrow plasma cell infiltration did not correlate with OS. Conclusions: MM is still diagnosed too late, by which time patients have developed almost irreversible complications. However, we confirmed that novel treatments improve OS in these patients, especially when used in addition to auto-HSCT. These findings may facilitate clinical therapeutic decision making.
Keywords
autologous hematopoietic stem-cell transplant, bortezomib, chemotherapy, multiple myeloma, overall survival


Title
Survival in patients with multiple myeloma: a real-life single-center study
Journal
Issue
Article type
Original research article
Pages
201-206
Published online
2022-06-06
Page views
2072
Article views/downloads
172
DOI
10.5603/AHP.a2022.0024
Bibliographic record
Acta Haematol Pol 2022;53(3):201-206.
Keywords
autologous hematopoietic stem-cell transplant
bortezomib
chemotherapy
multiple myeloma
overall survival
Authors
Marek Rodzaj
Anna Morawska-Krekora
Malgorzata Razny
Beata Jakubas


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