StemCell Therapy

Patientswith multiple myeloma (MM) had significant improvements in 5-year relativesurvival across all age groups since 1982, according to study results publishedin the British Journal of Haematology.The investigators noted that some improvements aligned with the historicalintroduction of treatment standards.

Ateam of investigators leveraged data from the Cancer Registry of Norway, whichhas required compulsory reporting of all cancer cases by the countrys hospitals,laboratories, and general practitioners since 1953. They also obtained nationwidemyeloma drug consumption statistics from the Norwegian Institute of PublicHealth.

Toinvestigate the countrys trends in incidence and relative survival in MM, theinvestigators separated all patients who were diagnosed with MM between 1982and 2017 (excluding incidental MM diagnosed at death/autopsy or no follow up) into3 age-based categories: younger than 65 years (transplant eligible), 65 to 79years (youngest transplant ineligible) and aged 80 years or older (oldesttransplant ineligible). Follow up for each patient continued until death,emigration, or the end of the study.

Theythen split the historical periods into 7 categories based on the introductionof treatment standards: 1982 to 1987 and 1988 to 1992 (melphalan-prednisone),1993 to 1997 (early high-dose melphalan followed by autologous stem celltransplant), 1998 to 2002 (introduction of thalidomide), 2003 to 2007 (earlythalidomide upfront, introduction of bortezomib), 2008 to 2012 (thalidomide andbortezomib upfront, introduction of lenalidomide), and 2013 to 2017(lenalidomide upfront, early pomalidomide, daratumumab, panobinostat, andcarfilzomib).

Forthe 10,524 patients included in the study, the median age at diagnosis was 71years; 53.7% were men. The median follow up was 2.4 years with 8458 deaths and 10emigrations.

The age-standardized incidence rate between 1982 and 2017 shifted from stable to increasing starting at approximately the year 2000. From 2014 to 2017, the incidence rate of MM standardized to the Norwegian population increased from 7.3 to 8.4. The authors suggested that these increases over time are likely attributable to increased use of certain biomarkers and diagnosis of smoldering MM.

Forpatients younger than 65 years, the 5-year and 10-year relative survival steadilyincreased over all time periods. For patients aged 65 to 79 years, both 5-yearand 10-year relative survival were stable until approximately 1998 to 2002, correspondingto the introduction of thalidomide, after which both increased. For patientsaged 80 years or older, the 5-year relative survival increased from the firstto last time period from 0.11 to 0.28).

Somestudy limitations included that cancer registry did not differentiate between smolderingand active MM nor did it include individual information on clinical features,treatment, or biomarkers.

Inconclusion, we demonstrate a significant improvement in 5-year [relativesurvival] in all age groups. Improved [relative survival] in patients aged 80years at the time of diagnosis is only rarely described in otherpopulation-based studies, wrote the authors. For patients aged 65 years, theimprovement in [relative survival] coincides with the introduction of moderndrugs, whereas patients aged <65 years had an ongoing improvement before theintroduction of autologous stem-cell transplant.

Langseth O, Myklebust T, Johannesen TB, Hjertner , Waage A. Incidence and survival of multiple myeloma: a populationbased study of 10524 patients diagnosed 19822017 [published online May 5, 2020]. Br J Haematol. doi: 10.1111/bjh.16674

Read more:
Steady Improvements in the Survival of Norwegian Patients With Multiple Myeloma - Hematology Advisor

This entry was posted on May 23, 2020 at 3:46 pm and is filed under Death by Stem Cells. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed. |