Saeed Nadia, Ahmad Usman, Moosajee Munira, Niazi Zeeshan Ahmed Khan, Siddiqui Neelam, Aziz Zeba, Khan Danish Hassan, Iftikhar Faiza, Ahmad Imran Nazir, Mir Muhammad Ayaz
Shifa College of Medicine, Shifa Tameer E Millat University, Islamabad, Pakistan.
Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Indian J Hematol Blood Transfus. 2022 Apr;38(2):309-318. doi: 10.1007/s12288-021-01485-y. Epub 2021 Sep 2.
This is the first multicenter study from Pakistan exploring the prevalence, clinical presentations and treatment outcomes of Multiple Myeloma patients. This retrospective study involved data collection from hospital record system of four tertiary care referral hospitals of Pakistan including all patients diagnosed as having Multiple Myeloma from January 2014 to December 2018. The demographic details, clinical presentations, laboratory findings, treatment responses, and mortalities were evaluated. The progression-free survival and overall survival were analyzed considering relapse and mortality as the end points, respectively. For the progression-free survival, the Kaplan-Meier survival analysis and the log rank test were used to compare the survival function for chemotherapy followed by autologous stem cell transplant (ASCT) as opposed to chemotherapy alone (non-ASCT). The overall survival analysis was assessed by Kaplan-Meier survival analysis. This study identified 403 Multiple Myeloma patients in five years. The median age at presentation was 55 years. Bortezomib based drug regimens were the most commonly used initial treatments (57.5%). Forty three patients received ASCT. The progression-free survival median for ASCT and non-ASCT patients were 50 months (95% CI, 42-57.9 months) and 26 months (95% CI, 21.5-30.5 months), respectively. The cumulative probability of survival rate at 60 months was 80%. This study identified 403 Multiple Myeloma patients over 5 years in four tertiary care hospitals of Pakistan. It underscores the importance of autologous stem cell transplant in Myeloma patients and advocates improving its facilities in Pakistan.
这是来自巴基斯坦的第一项多中心研究，旨在探索多发性骨髓瘤患者的患病率、临床表现及治疗结果。这项回顾性研究涉及从巴基斯坦四家三级医疗转诊医院的医院记录系统收集数据，包括2014年1月至2018年12月期间所有被诊断为患有多发性骨髓瘤的患者。对人口统计学细节、临床表现、实验室检查结果、治疗反应及死亡率进行了评估。分别将复发和死亡作为终点，分析无进展生存期和总生存期。对于无进展生存期，采用Kaplan-Meier生存分析和对数秩检验来比较化疗后进行自体干细胞移植（ASCT）与单纯化疗（非ASCT）的生存函数。总生存期分析通过Kaplan-Meier生存分析进行评估。本研究在五年内共识别出403例多发性骨髓瘤患者。发病时的中位年龄为55岁。基于硼替佐米的药物方案是最常用的初始治疗方法（57.5%）。43例患者接受了ASCT。接受ASCT和非ASCT治疗的患者的无进展生存期的中位数分别为50个月（95%CI，42 - 57.9个月）和26个月（95%CI，21.5 - 30.5个月）。60个月时的累积生存率为80%。本研究在巴基斯坦的四家三级医疗医院中，在五年内共识别出403例多发性骨髓瘤患者。它强调了自体干细胞移植在骨髓瘤患者中的重要性，并倡导在巴基斯坦改善其相关设施。
