Pb2167 Epidemiological Data on Multiple Myeloma in Kosovo Between 2009 ‐ 2018

Abstract

Background:Multiple myeloma (MM), a malignant plasma cell disorder, constitutes about 1% of all reported neoplasms and 12% to 15% of hematologic malignancies. It is mainly a disease of the elderly which has a steep increase in incidence with advancing age. Reported incidence rates vary substantially worldwide (from 0.4 to 5 per 100,000 persons/years) but to what extend this variation is real or can be explained by differences in access to health care and other factors is unclear. Kosovo is the ‘youngest’ country in Europe and since the end of the war in 1999, is facing its own battles to provide qualitative, accessible, and sufficient health care services to its citizens. Interestingly, to date there are no epidemiological studies on MM cases.Aims:To evaluate the incidence, prevalence, patient age, sex, MM subtype, and treatment in Kosovo between the time periods of 2009‐2018.MethodsWe collected and studied the data of all the patients more than 35 years old hospitalized and diagnosed with MM in the University Clinical Centre of Kosovo during the period from 2009‐2018. Data were collected with PC Windows Excel and analyzed using GraphPad Prism 7.Results:According to the data collected and analyzed in the period from 2009‐2018, the total number of the patients diagnosed with MM in our clinic was 144. From all the patients diagnosed with MM, 89 (61.8%) were males and 55 (38.2%) females. The median age at diagnosis was about 65 years: 10.07 percent were younger than 50 years and only 0.7 percent were under 40 years. The main subtypes were IgG (55%), followed by IgA (23.3%), Kappa (9.3%), Lambda (5.6%), IgD (2.8%), Biclonal Gamapathy (2.8%) and IgM (0.9%). Approximately 88% of patients were secretory myeloma and about 12% of patients were oligo‐nonsecretory Myeloma at diagnosis. Among the patients diagnosed with MM 33% of them have been presented for the first time in hospital with bone pain, 28% with symptoms of anemia, 22% with high sedimentation rate and 17% with renal insufficiency. Because of economic burden the main treatment was with VAD protocol, followed by CTD and at a lower percentage with VCD/VTD plus minus bone marrow auto transplantation, mostly integrated in the last two years. The annual incidence of MM was about 0.8 new cases per 100,000 persons.The annual incidence rate of MM was about 0.8 new cases per 100,000 persons. The annual incidence for males and females was respectively 0.49 new MM cases per 100,000 persons and 0.30 new MM cases per 100,000 persons. The incidence was higher in males compared to females with a ratio of 1.6:1. The lowest incidence rate was in 2011 and this increased by 2.7‐fold to reach the highest recorded level in 2014. The estimated prevalence of MM in Kosovo is about 2.55 per 100,000 persons. Nearly 70% of those diagnosed and treated between 2009‐2018 had died by the end of 2018.Summary/Conclusion:MM is a disease presented in Kosovo with the annual incidence of about 0.8 new cases per 100,000 persons and a prevalence of about 2.55 per 100,000 persons affecting more males than females. The survival rate of patients by the end of 2018 was nearly 30%. These numbers may be higher as a significant proportion of the population chooses to be diagnosed and treated in neighboring countries due to the lack of diagnostic outcomes available. Although data on key epidemiological outcomes in MM in Kosovo is limited as there is only one university center in the whole country, this is a novel study that provides insight to the burden of this disease to Kosovo patients and the health system.image