Clinical and epidemiological features of multiple myeloma patients from a low socio-economic region of Brazil

Minnicelli, Carolina; Maciel, J.F.R.; Hassan, Rocı́o; Lemos, Telma Maria Araújo Moura

doi:10.1016/j.bjhh.2015.05.007

Cited by 6 publications

(6 citation statements)

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“…Argentina and Colombia—where most patients in the sample were treated at private clinics—were characterized by high rates of ASCT and bortezomib utilization in LOT1 relative to Brazil and Mexico, where most patients were treated at public hospitals. The low rate of bortezomib use as LOT1 in Brazil and Mexico are consistent with a case series of 65 Brazilian patients diagnosed with MM between 2006 and 2014 and a case series of 77 Mexican patients diagnosed in 2007–2016 who were treated at public hospitals (Minnicelli et al , ; Tarin‐Arzaga et al , ).…”

Section: Discussionsupporting

confidence: 75%

Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Hungria¹,

Martínez-Baños

Peñafiel

et al. 2019

Br J Haematol

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Limited data are available regarding contemporary multiple myeloma (MM) treatment practices in Latin America. In this retrospective cohort study, medical records were reviewed for a multinational cohort of 1103 Latin American MM patients (median age, 61 years) diagnosed in 2008-2015 who initiated first-line therapy (LOT1). Of these patients, 33Á9% underwent autologous stem cell transplantation (ASCT). During follow-up, 501 (45Á4%) and 129 (11Á7%) patients initiated second-(LOT2) and thirdline therapy (LOT3), respectively. In the LOT1 setting, from 2008 to 2015, there was a decrease in the use of thalidomide-based therapy, from 66Á7% to 42Á6%, and chemotherapy from, 20Á2% to 5Á9%, whereas use of bortezomib-based therapy or bortezomib + thalidomide increased from 10Á7% to 45Á5%. Bortezomib-based therapy and bortezomib + thalidomide were more commonly used in ASCT patients and in private clinics. In non-ASCT and ASCT patients, median progression-free survival (PFS) was 15Á0 and 31Á1 months following LOT1 and 10Á9 and 9Á5 months following LOT2, respectively. PFS was generally longer in patients treated with bortezomib-based or thalidomide-based therapy versus chemotherapy. These data shed light on recent trends in the management of MM in Latin America. Slower uptake of newer therapies in public clinics and poor PFS among patients with relapsed MM point to areas of unmet therapeutic need in Latin America.

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Section: Discussionsupporting

confidence: 75%

Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Hungria¹,

Martínez-Baños

Peñafiel

et al. 2019

Br J Haematol

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“…Llamó la atención que no observamos un predominio de sexo masculino, a diferencia de lo descrito internacionalmente 10 . Este fenómeno ya había sido reportado antes en Chile por Conte et al 4 y por Minnicelli et al 11 , en una cohorte brasileña de bajo nivel social. La razón requiere mayor estudio, sin embargo, podría deberse a que los pacientes latinoamericanos de sexo femenino (particularmente las de menos recursos) hacen mayor uso del sistema de atención de salud.…”

Section: Discussionunclassified

Mieloma múltiple en Chile: pasado, presente y futuro del programa nacional de drogas antineoplásicas (PANDA). Revisión de 1.103 pacientes

Peña

Rojas

Rojas³

et al. 2018

Rev. méd. Chile

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Survival of 1,103 Chilean patients with multiple myeloma receiving different therapeutic protocols from 2000 to 2016 Background: Multiple myeloma (MM) is one of the most common malignancies found in hematology. Aim: To describe the features of patients with MM and perform a survival analysis according to the different treatment protocols used between 2000 and 2016. Material and Methods: Analysis of the database of the Chilean national anti-neoplastic drug program. Information was obtained from 1,103 patients, with a median age of 64.5 years (range 27-95) and a male to female ratio of 1:1.2. Results: The mean overall survival (OS) of patients receiving or not receiving Thalidomide was 46 and 30 months, respectively (p < 0.01). The mean OS of patients treated before 2007 (treated with melphalan and prednisone) and between 2007 and 2012 (treated with thalidomide and dexamethasone) was 36 and 48 months respectively. In the group starting in 2013 (treated with cyclophosphamide, thalidomide and dexamethasone) the median survival had not been reached at 20 months of follow up (p = 0.01 for all comparisons). Autologous transplantation (AT) was carried out in only 18% of the eligible patients. The median OS of the patients who receive an AT had not been reached at 48 month compared with 36 month among those who did not received the procedure (p < 0.01). Conclusions: Even though overall survival has improved with time, new drugs must be introduced in our protocols to obtain similar results to those obtained worldwide.

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“…3 Regarding Latin American epidemiological datasets, little is known about the incidence and clinical features, 3,4 and the exact incidence of MM in Brazil has not yet been determined, 4,5 but according to the International Myeloma Foundation, there are around 30,000 Brazilian MM patients currently under treatment. 6 The management of MM has been revolutionized over the last few years and this has been based on understanding recent advances in MM pathophysiology, discovery of new target pathways and development of novel therapeutic agents. 7 Over the last nine years, Albert Einstein Hospital (São Paulo, SP, Brazil), in collaboration with MD Anderson…”

Section: Introductionmentioning

confidence: 99%

Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

et al. 2016

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CONTEXT AND OBJECTIVE: For the last nine years, hematologists and oncologists have gathered annually at an educational symposium organized by a Brazilian and an American hospital. During the 2015 Board Review, a survey among the attendees evaluated the differences in management and treatment methods for multiple myeloma (MM). DESIGN AND SETTING: Cross-sectional study during an educational hematology symposium in São Paulo, Brazil. METHODS: Hematologists present at the symposium gave responses to an electronic survey by means of mobile phone. RESULTS: Among the 350 attendees, 217 answered the questionnaire. Most of the participants believed that immunotargeting agents (iTA) might be effective for slowing MM progression in heavily pretreated patients (67%) and that continued exposure to therapy might lead to emergence of resistant clones in patients with MM (76%). Most of the physicians use maintenance therapy after hematopoietic stem cell transplantation (95%) and 45% of them would further restrict it to post-transplantation patients with underlying high-risk disease. The first-line drugs used for transplantation-ineligible patients (TI-MM) were bortezomib-thalidomide-dexamethasone (31%), bortezomib-dexamethasone (28%), lenalidomide-dexamethasone (Rd; 17%) and melphalan-based therapy (10%). Lenalidomide was the drug of choice for post-transplantation maintenance for half of the participants. No significant differences were observed regarding age or length of experience. CONCLUSION: The treatment choices for TI-MM patients were highly heterogenous and the melphalan-based regimen represented only 10% of the first-line options. Use of maintenance therapy after transplantation was a common choice. Some results from the survey were divergent from the evidence in the literature.

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Clinical and epidemiological features of multiple myeloma patients from a low socio-economic region of Brazil

Cited by 6 publications

References 10 publications

Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Multiple myeloma treatment patterns and clinical outcomes in the Latin America Haemato‐Oncology (HOLA) Observational Study, 2008–2016

Mieloma múltiple en Chile: pasado, presente y futuro del programa nacional de drogas antineoplásicas (PANDA). Revisión de 1.103 pacientes

Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study

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