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

Abstract

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.

Prognostic impact of renal failure recovery in patients with newly diagnosed multiple mieloma

“…We reported a 15-month median survival, which is similar to that period. This could be explained by the fact that there was a suboptimal treatment in our cohort, with no patients receiving bortezomib 19 nor high dose of dexamethasone 20 , some of them receiving doublets rather than triplets 21 , and with very few patients undergoing transplant 22 .…”

Mieloma múltiple en Chile: Respuesta a tratamiento en pacientes con mieloma múltiple elegibles para trasplante autólogo de progenitores hematopoyéticos

“…En cuanto a características demográficas y clínicas, llamó la atención el predominio del sexo femenino. Ya había sido reportado en un estudio chileno publicado 8 . Solo encontramos esta pre-figura 4.…”

“…Es más, menos de 10% de los candidatos a TAPH los recibió como quimioterapia de rescate. En otro estudio brasileño, que incluyó MM diagnosticados desde 2006 al 2014, el régimen más usado fue el CTD, usado en 50,7% 8 .…”

“…En el reporte de Hungria et al 10 , el TAPH se realizó a 26,9% de los pacientes, un 58,6% de los candidatos. Según lo reportado por Peña et al 8 , en Chile sólo logran trasplante 6,6% del total de los pacientes con MM, y 18% de los que se consideran candidatos, una cifra inaceptable. Nuestro reporte va en esa línea, ya que encontramos que sólo 23% de los candidatos a TAPH en el sistema público chileno reciben finalmente este procedimiento.…”

Next-Generation Biomarkers in Multiple Myeloma: Understanding the Molecular Basis for Potential Use in Diagnosis and Prognosis

“…In the United States of America, more than 230,000 cases of MM were reported between 2011 and 2016 [ 5 , 8 ]. The overall survival (OS) of MM patients was 30 months and could be extended to 46 months with Thalidomide treatment, and 48 months by BM transplantation [ 9 ]. More importantly, the survival rate is lower in patients with a higher ISS stage, suggesting that an early and competent diagnosis of MM may promote the survival rate [ 10 ].…”