Trends in survival from myeloma, 1990–2015: a competing risks analysis

Abstract

Background Myeloma survival has greatly increased over past decades. We investigated trends in survival over time in New Zealand by age, ethnicity, and geography and thus examined potential inequalities among these population subgroups. Methods From data supplied by the New Zealand Ministry of Health, all new diagnoses of multiple myeloma (ICD-10 code C90) between 1990 and 2016 were extracted, as well as their matched mortality data. Cox’s proportional hazards regression and competing risks regression were used to estimate multivariable survival functions. Results Between 1 January 1990 and 1 December 2015, 6642 myeloma cases were registered by the New Zealand Cancer Registry. Although survival from myeloma increased substantially from 1990–1994 to 2010–2015, 5-year survival was still only about 60% in 2010–2015. The greatest improvement in survival was for people aged 60–69 years at diagnosis. Using Cox’s proportional hazards regression, Māori showed an increased risk of myeloma death but this was predominantly due to differences in competing risks among ethnic groups. Competing risks analysis found the greatest improvement in myeloma survival in Pacific Islanders, and in 2010–2015 Māori had better survival than other ethnicities. Myeloma survival improved significantly over time in all regional health authorities but in all time periods the Central and Southern regions had significantly poorer survival than the Midland region. Conclusions Improvements in myeloma survival have been unequal across subgroups and regions in New Zealand. Detailed information about utilization of chemotherapeutic agents and transplantation in New Zealand is not available. This information, as well as more detailed hematological data, is essential to further explore the relationships and reasons for differing myeloma survival in population subgroups of New Zealand.

Time trends in survival and causes of death in multiple myeloma: a population-based study from Germany

“…Five-year RS estimates are presented in Figure 1 and in and 1990-2016, respectively, reporting that the main improvement of survival was achieved from 1999 onwards, that is, in the period covered by our analysis [5,22]. Our 5-year RS estimates from the most recent period are overall comparable to data from other cancer registries, apart from differences in the age groups included [5,23,24].…”

Allogeneic hematopoietic stem cell transplantation in patients with therapy‐related hematologic malignancies developing after multiple myeloma

“…Over the last few decades, the advent of new drugs and changing treatment practices (such as the use of long-term maintenance therapy) have led to an improvement in the prognosis of patients with multiple myeloma (MM), with 5-year survival rates reaching 50% in recent studies. 1,2 The increased life expectancy has led to an increased incidence of secondary malignancies including therapyrelated myeloid and lymphoid neoplasms in these patients. Patients with MM have been reported to have an 11.5-fold increased risk of developing therapy-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/t-AML).…”

Gaps and opportunities in the treatment of relapsed-refractory multiple myeloma: Consensus recommendations of the NCI Multiple Myeloma Steering Committee

“…The treatment of multiple myeloma has evolved dramatically. The introduction of several new drugs has led to the development of effective combinations, resulting in significant improvement in overall survival [1][2][3][4]. Several classes of agents, including proteasome inhibitors (PIs), immunomodulatory agents (IMiDs), alkylators, histone deacetylase inhibitors (HDACi), monoclonal antibodies (MoAbs), antibody drug conjugates (ADC), a novel selective inhibitor of nuclear export (SINE), and, more recently, chimeric antigen receptor T cells, have been approved for treatment of myeloma and used (either alone or in combination) at various stages of the disease [5].…”