Survival Outcomes of Newly Diagnosed Multiple Myeloma at a Tertiary Care Center in North India (IMAGe: 001A Study)

Abstract

PURPOSE The outcomes of patients with myeloma from developing countries are often lacking because of poor record maintenance. Publications from such settings are also limited because of the retrospective nature of the data collection. Information technology can bridge these gaps in developing countries with real-time data maintenance. We present the real-time survival data of the patients with myeloma from a tertiary care center in North India using one such indigenously built software. PATIENTS AND METHODS These are real-time data of all patients with myeloma presenting to a tertiary care center from North India. The patient characteristics (demographics, baseline disease characteristics, risk stratification, and outcomes) were recorded contemporaneously. The survival of the study population was analyzed and grouped based on various disease characteristics at diagnosis. RESULTS The median age of the study population (N = 696) was 65.9 (34.9-94.9) years with male predominance (65%). The median follow-up was 3.7 years (0-18.6 years) with the median overall survival (OS) not achieved. The OS of the study population at 1, 3, and 5 years was 94% (n = 558), 87.5% (n = 394), and 83.1% (n = 267), respectively. Most of the patients presented in advanced stages based on International Staging System (III:70%). On Kaplan-Meier analysis, the presence of weight loss ( P = .01), renal dysfunction ( P = .047), and anemia at diagnosis ( P = .004) had a significant impact on survival. On Cox proportional model univariate analysis, the presence of renal dysfunction, anemia, and weight loss had the significant hazard ratio of 1.68 (1-2.82, P = .049), 3.18 (1.39-7.29, P = .0063), and 2.81 (1.22-6.42, P = .014), respectively, whereas on multivariate analysis of hypercalcemia, renal disease, anemia, and bone disease (CRAB) features, only anemia was found to have a significant hazard ratio of 2.56 (1.01-6.47, P = .046). CONCLUSION The real-world data show OS comparable with the published western literature. Only anemia was found to have significant impact on survival. The use of such software can aid in better data-keeping in resource-constrained settings.

Profile and outcome of multiple myeloma with and without HIV treated at a tertiary hospital in KwaZulu-Natal, South Africa

“…Contrary to our study findings, MM is globally known to predominantly affect African males [ 5 , 7 , 9 , 14 , 33 , 34 ]. In 2009, another South African study by Rankapole et al, found a similarly higher proportion of females with MM and the South African National Institute of Communicable Diseases National Cancer Registry, also recorded an increasing incidence of MM in African females from 2016–2018 [ 6 , 14 ].…”

“…Anaemia is reportedly the most common presenting complaint in MM, and this concurred with our laboratory findings [ 7 , 33 , 48 ]. However, patients predominantly complained of bone pain rather than symptoms of anaemia, upon presentation to hospital.…”

Mechanistic Studies and a Retrospective Cohort Study: The Interaction between PPAR Agonists and Immunomodulatory Agents in Multiple Myeloma

“…MM is more common in elderly individuals; patients in this age group often suffer from other comorbidities such as diabetes and dyslipidemia [ 4 , 5 , 6 ]. Over 1 in 4 patients with MM has diabetes and 29.3% of myeloma patients have dyslipidemia [ 7 ].…”

“…Peroxisome proliferator-activated receptor (PPAR) agonists are U.S. Food and Drug Administration (FDA)-approved drugs indicated for use in type 2 diabetes and dyslipidemia [ 8 , 9 ]. Both the comorbidities and their treatment can have a severe impact on patients or can severely interact with the natural biology of MM [ 4 ].…”

Renal outcomes in myeloma associated acute kidney injury; a single centre experience

“…MCN was present in 86.6% of the patients with severe AKI (4). Around 50 % to 60% of MM patients with renal impairment have complete renal recovery (5) and overall survival of MM patients is related with the extent of renal recovery (5,6). With the introduction of bortezomib based chemotherapy there is improved overall survival and renal function in MM (7).…”