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2007-2018 年按移植状态分层的新诊断多发性骨髓瘤患者的生存和结局:来自加拿大骨髓瘤研究组数据库的回顾性分析。

Survival and Outcomes of Newly Diagnosed Multiple Myeloma Patients Stratified by Transplant Status 2007-2018: Retrospective Analysis from the Canadian Myeloma Research Group Database.

机构信息

Juravinski Cancer Center, Hamilton, Ontario, Canada.

Canadian Myeloma Research Group, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

出版信息

Clin Lymphoma Myeloma Leuk. 2022 Aug;22(8):608-617. doi: 10.1016/j.clml.2022.03.002. Epub 2022 Mar 8.

Abstract

BACKGROUND

Considerable progress has been made in therapeutic options for multiple myeloma (MM). Understanding the current landscape of MM treatment options and associated outcomes in the real world is important in providing key insights into clinical and knowledge gaps which could be targeted for further optimization.

METHODS

The Canadian Myeloma Research Group Database (CMRG-DB) is a prospectively maintained disease-specific database with >7000 patients. The objective of this study was to describe the trends in the treatment landscape and outcomes including early mortality, time to next treatment, and overall survival (OS) in each line of treatment stratified by autologous stem cell transplant (ASCT) receipt among newly-diagnosed MM patients in Canada between 2007 and 2018.

RESULTS

A total of 5154 patients were identified among which 3030 patients (58.8%) received an upfront ASCT and 2124 (41.2%) did not. At diagnosis, the median age was 64 years and 58.6% were males. Bortezomib and lenalidomide were most frequently used (>50%) in first and second-line treatment respectively among both the ASCT and non-ASCT cohort. The median OS was 122.0 months (95% Cl 115.0-135.0 months) and 54.3 months (95% CI 50.8-58.8 months) for the ASCT and non-ASCT cohort respectively with an incremental decrease in OS in each subsequent line of treatment.

CONCLUSION

We present the largest study to date in the Canadian landscape showing the characteristics, therapy usage, and outcomes among MM patients. This information will be critical in benchmarking current outcomes and provide key insight into areas of unmet needs and gaps for improvement of MM patients nationally.

摘要

背景

多发性骨髓瘤(MM)的治疗选择取得了相当大的进展。了解真实世界中 MM 治疗选择的现状和相关结果,对于提供临床和知识差距的关键见解,从而进一步优化治疗非常重要。

方法

加拿大骨髓瘤研究组数据库(CMRG-DB)是一个前瞻性维护的疾病特异性数据库,拥有超过 7000 名患者。本研究的目的是描述 2007 年至 2018 年期间加拿大新诊断 MM 患者的治疗格局和结果趋势,包括按自体干细胞移植(ASCT)接受情况分层的各线治疗中的早期死亡率、下一次治疗时间和总生存(OS)。

结果

共确定了 5154 名患者,其中 3030 名患者(58.8%)接受了一线 ASCT,2124 名患者(41.2%)未接受 ASCT。诊断时,中位年龄为 64 岁,男性占 58.6%。硼替佐米和来那度胺分别是 ASCT 和非 ASCT 队列中一线和二线治疗中最常用的药物(>50%)。ASCT 和非 ASCT 队列的中位 OS 分别为 122.0 个月(95%Cl 115.0-135.0 个月)和 54.3 个月(95%CI 50.8-58.8 个月),随着后续每一线治疗的进行,OS 呈递增性下降。

结论

我们展示了迄今为止在加拿大进行的最大规模研究,展示了 MM 患者的特征、治疗用药和结果。这些信息对于基准当前的结果非常关键,并为全国范围内 MM 患者的未满足需求和改进领域提供了关键的见解。

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