Jacob Linu Abraham, Suresh Babu M C, Lakshmaiah K C, Babu K Govind, Lokanatha D, Rajeev L K, Lokesh K N, Rudresha A H, Agarwal Ankit, Garg Sunny
Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
Indian J Cancer. 2017 Jan-Mar;54(1):340-342. doi: 10.4103/ijc.IJC_87_17.
Multiple myeloma (MM) is a plasma cell dyscrasias and an incurable clonal B-cell malignancy, with an annual incidence of 1% of all malignancies. The mainstay of treatment of myeloma is induction treatment followed by consolidation with autologous stem cell transplant (ASCT). However, still in a developing country like India where affordability is a major hurdle for health care, a number of MM patients are not able to undergo ASCT.
To study the epidemiological features and outcome of MM patients treated in a limited resource setting.
We conducted a retrospective study at our institute to identify patients diagnosed as MM from 2005 to 2016. We studied the epidemiological profile and the outcome of the treatment in terms of response rates and overall survival.
Survival analysis was performed using Kaplan-Meier curve.
Median age at diagnosis is 54 years (range: 39-85 years). IgG myeloma was the most common type seen in 72% of patients. The International Staging System (ISS) was ISS I (31%), ISS II (30%), and ISS III (39%). The median duration of treatment for thalidomide + dexamethasone (TD) and bortezomib + TD (VTD) was 9 and 7 months, respectively. Median survival for the TD versus VTD regimen (in a nontransplant setting) for the ISS I, ISS II, and ISS III groups was 49 and 55 months (P = 0.056), 42 and 48 months (P < 0.05), 21 and 27 months (P < 0.05), respectively.
Proteasome inhibitors significantly improved the median survival for patients with MM (ISS II and ISS III) treated in a limited resource setting.
多发性骨髓瘤（MM）是一种浆细胞发育异常疾病，是一种无法治愈的克隆性B细胞恶性肿瘤，在所有恶性肿瘤中的年发病率为1%。骨髓瘤治疗的主要方法是诱导治疗，随后进行自体干细胞移植（ASCT）巩固治疗。然而，在像印度这样的发展中国家，医疗费用可承受性是医疗保健的一个主要障碍，许多MM患者无法接受ASCT。
研究在资源有限的环境中接受治疗的MM患者的流行病学特征和治疗结果。
我们在本机构进行了一项回顾性研究，以确定2005年至2016年期间被诊断为MM的患者。我们从缓解率和总生存期方面研究了流行病学概况和治疗结果。
使用Kaplan-Meier曲线进行生存分析。
诊断时的中位年龄为54岁（范围：39 - 85岁）。IgG骨髓瘤是最常见的类型，见于72%的患者。国际分期系统（ISS）为ISS I期（31%）、ISS II期（30%）和ISS III期（39%）。沙利度胺 + 地塞米松（TD）和硼替佐米 + TD（VTD）的中位治疗持续时间分别为9个月和7个月。在非移植环境下，ISS I期、ISS II期和ISS III期组中TD方案与VTD方案的中位生存期分别为49个月和55个月（P = 0.056）、42个月和48个月（P < 0.05）、21个月和27个月（P < 0.05）。
蛋白酶体抑制剂显著提高了在资源有限环境中接受治疗的MM患者（ISS II期和ISS III期）的中位生存期。
