Survival of myeloma patients following the introduction of thalidomide as a second‐line therapy: a retrospective study at a single New Zealand centre
This retrospective study compares the overall survival (OS) of multiple myeloma (MM) patients following treatment at a New Zealand hospital over a period in which novel therapies were available but restricted, almost exclusively, to thalidomide as a second‐line therapy.
Clinical, laboratory and OS data were collected on 361 MM patients who were treated at Christchurch Hospital during 2000–2010. Patients were subdivided according to the clinical criteria used to determine front‐line treatment decisions. Older patients (age ≥66, n = 180) generally received standard‐dose chemotherapy without autologous stem cell transplant (SCT) and formed one group. Younger patients were further subdivided according to whether they received autologous SCT (n = 89), allogeneic SCT (n = 24) or no SCT (n = 68).
Older patients had a significantly shorter OS (P < 0.0001) than younger patients (median OS = 25 vs 78 months) however treated. Analysis of relative survival demonstrated that the increased mortality of older patients was greater than that attributable to normal ageing. Younger patients who received no transplant had a significantly shorter OS (P < 0.0001) than those who received autologous SCT or allogeneic SCT with 5‐year survivals of 38%, 70% and 72% respectively. Use of novel therapies was significantly higher in younger than older patients (60% vs 47%, P = 0.011).
The front‐line treatment groupings of hospital MM patients had significantly different survivals. The OS of SCT ineligible patients remains poor despite the introduction of thalidomide.
Document Type: Research Article
Publication date: 2013-02-01