A National Registry of Patients Diagnosed with Multiple Myeloma in Taiwan.

The diagnosis and treatment pattern in actual practice for patients with multiple myeloma has not been described in Taiwan. This is the first national registry survey with the introduction of conventional and novel anti-myeloma therapies in Taiwan.

The “Multiple Myeloma Observational Study” is a national-based observational registry survey conducted by the Hematology Society of Taiwan. All patients newly diagnosed with multiple myeloma within one year are eligible for inclusion. Information on treatment, treatment response and survival was obtained by medical record review. We report 115 patients with multiple myeloma in Taiwan who were enrolled from January 2006 to December 2008.

The characteristics of 115 patients were examined according to age, gender and disease stage. The average age was 65 years. The number of male patient was 72 (62.6%); female patient, 43 (37.4%). The proportions of disease stage were: stage I, 14 (12.2%); stage II, 26 (22.6%); stage III, 75 (65.2%). All patients had received anti-myeloma agents as their first line treatment since diagnosis. The most commonly used regimen was combination of melphalan, prednisolone and thalidomide in 27 patients (23.5%) and combination of thalidomide and dexamethasone in 27 patients (23.5%); followed by combination of melphalan and prednisolone, 24 (20.9%); combination of vincristine, anthracycline and dexamethasone (VAD), 15 (13%), thalidomide alone, 9 (7.8%); dexamethasone alone, 5 (4.3%); combination of VAD and thalidomide, 2 (1.7%); others, 3 (2.6%). The adjunct therapies along with first line treatment include zoledronic acid, 59 (51.3%); clodronate, 16 (13.9%); pamidronat, 8 (7.0%); and epoietin, 5 (4.3%). The outcomes of treatment were also recorded. The overall response rate for first line treatment was 59.1%. The best response of combination of VAD and thalidomide was 100%, followed by combination of thalidomide and dexamethasone, 66.7%; combination of melphalan and prednisolone, 66.7%; the combination of melphalan, prednisolone and thalidomide, 63%, combination of vincristine, anthracycline and dexamethasone, 60%; thalidomide alone, 22.2%; dexamethasone alone, 20%.

A total of 31 patients had received anti-myeloma agents as the second line treatment. The most commonly used treatment was thalidomide alone, received by 7 patients (22.6%); followed by combination of thalidomide and dexamethasone, 5 (16.1%); combination of melphalan, prednisolone and thalidomide, 5 (16.1%); VAD, 5 (16.1%); combination of melphalan and prednilolone, 3 (9.7%); dexamethasone alone, 3 (9.7%) and other regimen, 3 (9.7%). The overall response rate for second line treatment was 41.9%. The best response of the combination of melphalan, prednisolone and thalidomide, 66.7%, followed by combination of vincristine, anthracycline and dexamethasone, 60%; thalidomide alone 57.1%; the combination of thalidomide and dexamethasone, 40%. The median survival duration was still not achieved yet.

The results of this national registry show that the choice of treatments in multiple myeloma covers a wide range of therapeutic modality. The overall response of first line treatment and second line treatment was comparable to the result of other registry studies.

Chiou:Janssen-Cilag Taiwan: Honoraria, Research Funding. Lin:Janssen-Cilag Taiwan: Honoraria. Chang:Janssen-Cilag Taiwan: Honoraria. Hsiao:Janssen-Cilag Taiwan: Honoraria.