The Shreveport Myeloma Experience: Survival, Risk Factors and Other Malignancies in the Age of Stem Cell Transplantation

Abstract

Background: The overall prognosis of multiple myeloma has improved significantly over the last 15 years. We wondered whether the overall improvement would also be seen in unselected patients in an academic center in Northwest Louisiana with a high proportion of minority patients, and if second malignant neoplasms are relevant for our patients. Materials and Methods: Between 1998 and 2009, 215 patients were treated for multiple myeloma at our center and had complete follow-up until May 2013. Results: The mean survival of patients with multiple myeloma increased from 3.25 to 5.34 years, which is comparable to patients treated at larger centers. No prognostic difference was observed in the subgroups of myeloma patients. Among 215 patients followed for the development of secondary cancers, 16 already had a preexisting or concomitant malignancy (7.4%) and 10 developed secondary cancers. Our data indicate a significant background of histologically unrelated cancers and a cumulative incidence of new cancers of about 20% after 10 years of follow-up. Based on SEER data, preexisting or secondary cancers were not statistically increased in our population. Conclusions: The use of autologous transplantation and the introduction of new agents resulted in a significant improvement in the prognosis of multiple myeloma. Other cancers are not statistically increased before or after multiple myeloma is diagnosed and are not prognostically relevant.

Autologous Stem Cell Transplantation for Multiple Myeloma: Single Centre Experience from North India

“…Approximately 50% of our patients required 2 harvests. The median duration of neutrophils and platelet engraftment was 11 and 12 days respectively which is in consonance with international transplant data [33]. The mean duration of post-transplant hospital stay is 18 days similar to that by Kumar et al [24].…”

“…The mean duration of post-transplant hospital stay is 18 days similar to that by Kumar et al [24]. 74.41% of our study population developed febrile neutropenia which is higher than the international data on MM APBSCT [33].…”

Progress in multiple myeloma

“…The median overall survival of all patients was 7.5 years. These results were comparable to Western countries67. The authors need to be congratulated not only on their outcomes but also for their careful patient selection and long-term follow up.…”

“…Taken together, in Western countries, the prognosis of multiple myeloma has significantly improved over the last 25 years. Part of this improvement is due to the utilization of novel therapies including high-dose chemotherapy followed by autologous stem transplantation4567.…”

Impact of health care insurance on overall survival of patients with multiple myeloma and monoclonal gammopathy of undetermined significance

“…[11][12][13][14] Advances in therapeutic options such as proteasome inhibitors, immune modulatory drugs (IMDs) and stem cell transplantation (SCT) have improved the prognosis and survival of patients with MM. [15,16] Several drugs belonging to the class of proteasome inhibitors such as Bortezomib, Carfilzomib, Ixazomib, immunomodulators such as Lenalidomide, Pomalidomide and monoclonal antibodies such as Daratumumab and Elotuzumab have changed the landscape of treatment of multiple myeloma in the last decade. Patients with MGUS undergo active surveillance for progression to MM and do not receive active treatment.…”