Observational study of multiple myeloma in Latin America

Abstract

Relatively little is known about the outcomes of multiple myeloma in Latin America, a world region where incorporation of novel agents is generally slow. In the current retrospective-prospective study, we aimed to describe the patterns of care and treatment results in five Latin American countries. Between April 2007 and October 2009, patients who had been diagnosed from January 2005 to December 2007 were registered at 23 institutions from Argentina, Brazil, Chile, Mexico, and Peru. We divided patients into two cohorts, according to transplantation eligibility, and analyzed them with regard to first-line treatment and overall survival (OS). We analyzed a total of 852 patients, 46.9 % of whom were female. The median follow-up was 62 months. Among transplantation-ineligible patients (N = 461), the mean age was 67.4 years, approximately one third of patients received a thalidomide-based treatment in the first line, and the median OS was 43.0 months. Transplantation-eligible patients (N = 391) had a mean age of 54.7 years and a median OS of 73.6 months. Autologous transplantation was performed in 58.6 % of the patients for whom this procedure was initially planned and in only 26.9 % of the overall patients. Our long-term results reflect the contemporary literature for patients with multiple myeloma treated with autologous transplantation and thalidomide-based regimens in clinical trials and observational studies. However, further efforts are needed to approve and incorporate novel agents in Latin American countries, as well as to increase access to transplantation, in order to achieve the expected improvements in patient outcomes.

Geographic Hematology: Some Observations in Mexico

“…MM represents nearly 1% of all cancers and 15% of hematologic malignancies in the world [44,45]. However, its incidence varies among different regions and ethnic groups.…”

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

“…These real‐world data provide insights into contemporary practice patterns in the management of MM in Latin America, and contrast with treatment patterns observed in an earlier multinational Latin American registry study (Hungria et al , ). In that earlier registry study, which enrolled 852 MM patients diagnosed between 2005 and 2007 in Argentina, Brazil, Chile, Mexico and Peru, the majority of patients received chemotherapy, a minority received thalidomide‐based therapy, and none received bortezomib as LOT1.…”

“…Treatment start and end dates were captured for LOT1, LOT2 and LOT3; however, ASCT date was not abstracted. Because ASCT is typically given as part of LOT1 in transplant‐eligible patients (Hungria et al , ; Moreau et al , ; Multiple Myeloma NCCN Guidelines Panel, ), our analyses assume that ASCT was part of LOT1. As detailed in Table SII, for each line of therapy (LOT), antineoplastic therapeutic regimens were classified as follows: bortezomib‐based, thalidomide‐based, bortezomib + thalidomide, chemotherapy, corticosteroids only, or newer agents (lenalidomide‐ or carfilzomib‐based).…”

“…Limited data are available regarding contemporary MM treatment practices in Latin America. In a large multinational registry of Latin American MM patients diagnosed between 2005 and 2007, first‐line therapy did not include an immunomodulatory drug or a proteasome inhibitor for the majority of patients (Hungria et al , ). The present study builds upon prior research by describing recent trends in treatment patterns, access to care, and clinical outcomes in a large multinational cohort of MM patients.…”

Epidemiological and clinical characteristics and outcome of monoclonal gammopathy of renal significance‐related lesions in Latin America

“…Our cohort included rather young patients. It is important to remember that patients with MG‐related diseases in LA are younger than those in other geographical areas, which could in part explain our “young” cohort. However, this finding could also be related to the fact that renal biopsies are performed less frequently in elderly patients, due to comorbidities and possible complications.…”