Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry

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Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry. / Blimark, Cecilie Hveding; Turesson, Ingemar; Genell, Anna; Ahlberg, Lucia; Björkstrand, Bo; Carlson, Kristina; Forsberg, Karin; Juliusson, Gunnar; Linder, Olle; Mellqvist, Ulf Henrik; Nahi, Hareth; Kristinsson, Sigurdur Y.

I: Haematologica, Vol. 103, Nr. 3, 28.02.2018, s. 506-513.

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Blimark, CH, Turesson, I, Genell, A, Ahlberg, L, Björkstrand, B, Carlson, K, Forsberg, K, Juliusson, G, Linder, O, Mellqvist, UH, Nahi, H & Kristinsson, SY 2018, 'Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry', Haematologica, vol. 103, nr. 3, s. 506-513. https://doi.org/10.3324/haematol.2017.178103

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Blimark CH, Turesson I, Genell A, Ahlberg L, Björkstrand B, Carlson K, Forsberg K, Juliusson G, Linder O, Mellqvist UH, Nahi H, Kristinsson SY. 2018. Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry. Haematologica. 103(3):506-513. https://doi.org/10.3324/haematol.2017.178103

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Blimark, Cecilie Hveding ; Turesson, Ingemar ; Genell, Anna ; Ahlberg, Lucia ; Björkstrand, Bo ; Carlson, Kristina ; Forsberg, Karin ; Juliusson, Gunnar ; Linder, Olle ; Mellqvist, Ulf Henrik ; Nahi, Hareth ; Kristinsson, Sigurdur Y. / Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry. I: Haematologica. 2018 ; Vol. 103, Nr. 3. s. 506-513.

RIS

TY - JOUR

T1 - Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry

AU - Blimark, Cecilie Hveding

AU - Turesson, Ingemar

AU - Genell, Anna

AU - Ahlberg, Lucia

AU - Björkstrand, Bo

AU - Carlson, Kristina

AU - Forsberg, Karin

AU - Juliusson, Gunnar

AU - Linder, Olle

AU - Mellqvist, Ulf Henrik

AU - Nahi, Hareth

AU - Kristinsson, Sigurdur Y.

PY - 2018/2/28

Y1 - 2018/2/28

N2 - Epidemiology and outcome of myeloma are mainly reported from large university centers and collaborative groups, and do not represent ‘real-world’ patients. The Swedish Myeloma Registry is a prospective population-based registry documenting characteristics, treatment and outcome in newly diagnosed myeloma, including asymptomatic and localized forms, with the purpose of improving disease management and outcome. This report presents information on patients diagnosed between 2008 and 2015, including data on first-line treatment in patients diagnosed up to 2014, with a follow up until December 2016. We present age-adjusted incidence, patients’ characteristics at baseline, treatment, response, and survival. Baseline data were available with a 97% coverage in 4904 patients (median age 71 years, males 70 years, females 73 years; 72% were 65 years or older), and at 1-year follow up in 3558 patients with symptomatic disease (92% of patients initially reported). The age-adjusted incidence was 6.8 myeloma cases per 100,000 inhabitants per year. Among initially symptomatic patients (n=3988), 77% had osteolytic lesions or compression fractures, 49% had anemia, 18% impaired kidney function, and 13% hypercalcemia. High-dose therapy with autologous stem cell transplantation was given to 77% of patients aged up to 66 years, and to 22% of patients aged 66-70 years. In the study period, 68% received bortezomib, thalidomide, and/or lenalidomide as part of the first-line treatment, rising from 31% in 2008 to 81% in 2014. In active myeloma, the median relative survival of patients aged 65 years or under was 7.7 years, and 3.4 years in patients aged 66 years and over. Patients diagnosed with myeloma in more recent years were associated with significantly higher rates of complete or very good partial remission (P<0.05), and with a significantly higher survival, with a Hazard Ratio (HR) of 0.84 (95%CI: 0.77-0.92; P<0.05). There was a small, but significant survival benefit in patients treated at university hospitals (HR 0.93; 95%CI: 0.87-0.99; P<0.05). We report here on a near complete ‘real-world’ population of myeloma patients during an 8-year period; a period in which newer drugs were implemented into standard practice. The overall incidence and median age were both higher than in most previous studies, indicating a more complete coverage of older patients. Myeloma survival in Sweden is comparable to other large registry studies, and responses and survival improved during the study period.

AB - Epidemiology and outcome of myeloma are mainly reported from large university centers and collaborative groups, and do not represent ‘real-world’ patients. The Swedish Myeloma Registry is a prospective population-based registry documenting characteristics, treatment and outcome in newly diagnosed myeloma, including asymptomatic and localized forms, with the purpose of improving disease management and outcome. This report presents information on patients diagnosed between 2008 and 2015, including data on first-line treatment in patients diagnosed up to 2014, with a follow up until December 2016. We present age-adjusted incidence, patients’ characteristics at baseline, treatment, response, and survival. Baseline data were available with a 97% coverage in 4904 patients (median age 71 years, males 70 years, females 73 years; 72% were 65 years or older), and at 1-year follow up in 3558 patients with symptomatic disease (92% of patients initially reported). The age-adjusted incidence was 6.8 myeloma cases per 100,000 inhabitants per year. Among initially symptomatic patients (n=3988), 77% had osteolytic lesions or compression fractures, 49% had anemia, 18% impaired kidney function, and 13% hypercalcemia. High-dose therapy with autologous stem cell transplantation was given to 77% of patients aged up to 66 years, and to 22% of patients aged 66-70 years. In the study period, 68% received bortezomib, thalidomide, and/or lenalidomide as part of the first-line treatment, rising from 31% in 2008 to 81% in 2014. In active myeloma, the median relative survival of patients aged 65 years or under was 7.7 years, and 3.4 years in patients aged 66 years and over. Patients diagnosed with myeloma in more recent years were associated with significantly higher rates of complete or very good partial remission (P<0.05), and with a significantly higher survival, with a Hazard Ratio (HR) of 0.84 (95%CI: 0.77-0.92; P<0.05). There was a small, but significant survival benefit in patients treated at university hospitals (HR 0.93; 95%CI: 0.87-0.99; P<0.05). We report here on a near complete ‘real-world’ population of myeloma patients during an 8-year period; a period in which newer drugs were implemented into standard practice. The overall incidence and median age were both higher than in most previous studies, indicating a more complete coverage of older patients. Myeloma survival in Sweden is comparable to other large registry studies, and responses and survival improved during the study period.

UR - http://www.scopus.com/inward/record.url?scp=85042779638&partnerID=8YFLogxK

U2 - 10.3324/haematol.2017.178103

DO - 10.3324/haematol.2017.178103

M3 - Article

VL - 103

SP - 506

EP - 513

JO - Haematologica-The Hematology Journal

T2 - Haematologica-The Hematology Journal

JF - Haematologica-The Hematology Journal

SN - 1592-8721

IS - 3

ER -