The Myeloma Landscape in Australia and New Zealand: The First 8 Years of the Myeloma and Related Diseases Registry (MRDR)
Autor: | Tracy King, Erica M. Wood, New Zealand Myeloma, Zoe McQuilten, Cameron Wellard, Peter Mollee, Andrew Spencer, P. Joy Ho, Elizabeth Moore, Hilary Blacklock, Krystal Bergin, Hang Quach, Simon J Harrison, Patricia F. Walker |
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Rok vydání: | 2021 |
Předmět: |
Male
Cancer Research medicine.medical_specialty Clinical Decision-Making Context (language use) Comorbidity Monoclonal Gammopathy of Undetermined Significance law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Outcome Assessment Health Care medicine Humans Autologous transplantation Public Health Surveillance Registries Multiple myeloma Aged Aged 80 and over Hematology Performance status business.industry Australia Middle Aged Prognosis medicine.disease Combined Modality Therapy Clinical trial Clinical research Oncology 030220 oncology & carcinogenesis Female Disease Susceptibility Multiple Myeloma business New Zealand 030215 immunology |
Zdroj: | Clinical Lymphoma Myeloma and Leukemia. 21:e510-e520 |
ISSN: | 2152-2650 |
DOI: | 10.1016/j.clml.2021.01.016 |
Popis: | BACKGROUND: Real-world multiple myeloma (MM) data are scarce, with most data originating from clinical trials. The Myeloma and Related Diseases Registry (MRDR) is a prospective clinical-quality registry of newly diagnosed cases of plasma cell disorders established in 2012 and operating at 44 sites in Australia and New Zealand as of April 2020. METHODS: We reviewed all patients enrolled onto the MRDR between June 2012 and April 2020. Baseline characteristics, treatment, and outcome data were reviewed for MM patients with comparisons made by chi-square tests (categorical variables) and rank sum tests (continuous variables). Kaplan-Meier analysis was used to estimate progression-free survival and overall survival (OS). RESULTS: As of April 2020, a total of 2405 MM patients were enrolled (median age, 67 years, with 40% aged > 70 years). High-risk features were present in 13% to 31% of patients: fluorescence in-situ hybridization (FISH) ≥ 1 of t(4;14), t(14;16), or del(17p) 18%, International Staging System (ISS)-3 31%, and Revised ISS (R-ISS)-3 13%. Cytogenetic/FISH analyses were performed in 50% and 68% of patients, respectively, with an abnormal karyotype result in 34%. Bortezomib-containing therapy was the most common first-line therapy (79.3%, n = 1706). Patients not receiving bortezomib were older (median age, 76 vs 65 years, P < .001) with inferior performance status (Eastern Cooperative Oncology Group performance status ≥ 2, 41% vs 18%, P < .001). Median progression-free survival and OS were 30.8 and 65.8 months, respectively. Younger patients had superior OS (76.3 vs 46.7 months, P < .001, < 70 and ≥ 70 years, respectively). R-ISS score was available in 50.7% (n = 1220) of patients, and higher R-ISS was associated with inferior OS (R-ISS-1 vs R-ISS-2 vs R-ISS-3: not reached vs 68.1 months vs 33.2 months, respectively, P < .001). CONCLUSION: Clinical registries provide a more complete picture of MM diagnosis and treatment, and highlight the challenges of adhering to best practices in a real-world context. |
Databáze: | OpenAIRE |
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