Inland Northwest Myeloma/Lymphoma & Transplant Program of Cancer Care Northwest, Cancer Care Northwest, 601 S. Sherman Street, Spokane, WA 99202, USA.
Int J Hematol. 2012 Jan;95(1):64-70. doi: 10.1007/s12185-011-0971-z. Epub 2011 Dec 9.
With the availability of novel agents, the overall survival (OS) in patients diagnosed with multiple myeloma (MM) has improved over the last decade. Data on 40,294 MM patients in the years from 1973 to 2003 were obtained from the Surveillance, Epidemiology, and End Results Program (SEER) of the US National Cancer Institute. Statistical analyses evaluating gender, race, age, and year of diagnosis were performed using univariate and multivariate Cox regression models for the OS endpoint. The mean patient age at diagnosis was 68.3 years. Mean survival was 30 months (median = 19 months). Asian/Pacific Islander race was associated with an improved OS, HR 0.90 (CI 0.86-0.95, P < 0.001). American Indian/Alaska Native race was associated with a decreased OS, HR 1.18 (CI 1.01-1.38, P = 0.040). Multivariate analysis did not reveal statistically significant differences in OS between patients in the white and black race (P = 0.709). Younger age (age <65, and 65-75) was associated with improved OS when compared with patients >75 years of age (all P < 0.001). Recent treatment decades (1983-1992 and 1993-2003) were associated with improved OS on multivariate analysis with HR 0.88 (CI 0.88-0.89, P < 0.001) and HR 0.83 (CI 0.81-0.85, P < 0.001), respectively. As the largest population analysis to date, this study reveals a statistically significant improvement in OS for patients who were treated in more recent decades, even before the availability of novel agents. Patients who were <65 years of age and Asian/Pacific Islander race groups exhibited superior levels of OS, whereas American Indian/Alaska Native groups had decreased OS.
随着新型药物的出现，过去十年中多发性骨髓瘤（MM）患者的总生存率（OS）得到了提高。从美国国家癌症研究所的监测、流行病学和最终结果计划（SEER）中获取了 1973 年至 2003 年期间 40294 名 MM 患者的数据。使用单变量和多变量 Cox 回归模型对 OS 终点进行了性别、种族、年龄和诊断年份的统计分析。诊断时患者的平均年龄为 68.3 岁。平均生存时间为 30 个月（中位数=19 个月）。亚洲/太平洋岛民种族与改善的 OS 相关，HR 0.90（CI 0.86-0.95，P<0.001）。美洲印第安人/阿拉斯加原住民种族与降低的 OS 相关，HR 1.18（CI 1.01-1.38，P=0.040）。多变量分析并未显示白人和黑人种族之间 OS 存在统计学显著差异（P=0.709）。与年龄>75 岁的患者相比，年龄较轻（<65 岁和 65-75 岁）的患者 OS 得到改善（均 P<0.001）。最近的治疗十年（1983-1992 年和 1993-2003 年）与多变量分析中 OS 的改善相关，HR 分别为 0.88（CI 0.88-0.89，P<0.001）和 0.83（CI 0.81-0.85，P<0.001）。作为迄今为止最大的人群分析，本研究揭示了即使在新型药物出现之前，最近几十年接受治疗的患者的 OS 得到了统计学上的显著改善。年龄<65 岁和亚洲/太平洋岛民种族组表现出更高水平的 OS，而美洲印第安人/阿拉斯加原住民组的 OS 降低。
