Abstract
Introduction: Previous studies have described the profiles of patients with MM registered in LA (Haematologica 2008; Ann Hematol 2017) and in Asia (Am J Hematol 2014). We used these two datasets to compare patient profiles and overall survival (OS) in these two world regions.
Methods: 1124 patients from LA diagnosed between 1998 and 2004, and 844 diagnosed between 2005 and 2007 were eligible for the current analysis. Of the original 3405 patients from the Asian series, only the 1696 diagnosed from 1998 to 2007 were included. Demographic and clinical characteristics were described and compared between the two regions.
Results: The table displays the main characteristics in both regions. Among the known prognostic factors for OS, age, ISS stage, anemia and hypercalcemia had statistically significantly different distributions between the two regions. Patients from LA were younger and had more hypercalcemia/bone lesions than Asian patients, who had more anemia and more advanced ISS stage. There was a significant difference in OS between the two regions: median OS was 55.8 months in LA, and 46.5 months in Asia (hazard ratio [HR]=0.83; 95% CI, 0.73 - 0.92; P<0.001). In a Cox proportional hazards model with 2704 patients with complete data and adjusting for age, ISS stage, anemia and hypercalcemia, region retained its prognostic significance (HR=0.82; 95% CI, 0.73 - 0.92; P<0.001). HRs for age (as continuous variable), ISS (III vs I/II), anemia and hypercalcemia were 1.02, 1.71, 1.25 and 1.65, respectively (all P<0.001). The proportions of patients undergoing transplantation were 34.3% in LA and 26.9% in Asia (P<0.001).
Conclusions: Despite adverse prognostic features favoring patients from one region or the other, we found a significant difference in OS between contemporaneous patients from LA and Asia. Given the observational nature of the study, whether this finding underscores different biological features, different rates of transplantation, unmeasured confounders, or the play of chance, remains to be determined.
Hungria: Celgene, Roche, Takeda, Janssen, Amgen: Honoraria. Maiolino: Janssen, Takeda, Amgen, Celgene, Sanofi, Teva, Bristol,Novartis: Honoraria. De Queiroz Crusoe: Celgene, Janssen, Amgen, Takeda: Honoraria. Bittencourt: Janssen, Takeda: Honoraria. Fantl: varifarma: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Raffo: Speakers Bureau. Gomez-Almaguer: Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bristol: Consultancy, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees. Durie: Takeda: Consultancy; Amgen: Consultancy; Johnson & Johnson: Consultancy.
