Evaluation of our real-life data in multiple myeloma patients in the light of current treatments

Evaluation of Our Real-Life Data in Multiple Myeloma Patients in the Light of Current Treatments Objective: Multiple myeloma is a monoclonal gamopathy that accounts for 10% of hematologic malignancies. In this study, we aimed to evaluate the presenting complaints, performance status, laboratory results, factors affecting prognosis, treatment, progression-free survival and overall survival of patients with multiple myeloma in the light of current data. Materials and Methods: Between 2007-2019, 96 patients who were followed in Çukurova University Medical School Department of Hematology were retrospectively reviewed. Data regarding performance status of patients on admission, treatments given, responses, and survival were collected. International staging system (ISS) criteria were used for disease staging. Response assessment was based on international myeloma working group criteria. Results: The mean age of the patients was 60.3 ± 10 years, and the female / male ratio was 2/3. According to 'Revised myeloma comorbidity index' (R-MCI) 18 patients were classified as 0-3, 63 patients as 4-6, 11 patients as 7-9. There was a significant difference in overall survival which was longer in low R-MCI group of patients compared to other patient. (p=0,009) At presentation 56% (54) of the patients had bone pain, low back pain or fracture. The most commonly seen Ig type was IgG (%52 of patients); which was followed by IgA (%22), light chain type (%12,5) and non-secretory myeloma %6. Our results demonstrated that, patients who had CD56 positivity by immunohistochemical staining of bone marrow aspirates survived 59 months, while negative patients survived for 43 months. (p=0,03) The response rates of bortezomib based induction regimens were quite high (71%). When the responses were evaluated according to first line treatments, 69% of the patients given bortezomib-based triplet combination therapy had very good partial and better response, 40% of the patients given bortezomib-deksamethason combination had very good partial and better response, and 30% of the patients VAD regimen given had very good partial and better response was detected. Patients who had autologous stem cell transplantation (ASCT) had a life expectancy of 105 months versus 74 months in those without ASCT. (p=0,001); progression free survival (PFS) was 49 and 31 months respectively. (p=0,01) Conslusion: In parallel with recent developments, new treatment options in multiple myeloma patients in our country is applicable in induction phase of treatment as well as subsequent steps. We found that survival rates of our patients increased significantly compared to previous years. Despite of all these developments, it is seen that ASCT still seems to be an important option for patients with multiple myeloma when appropriate.