Yoon Junghyun, Jung Jongheon, Park Boyoung, Lee Eunyoung, Park YoungJu, Yoon Soomin, Eom Hyeon-Seok
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, 10408, Gyeonggi-do, Korea.
BMC Cancer. 2025 Feb 28;25(1):369. doi: 10.1186/s12885-025-13615-0.
The treatment landscape for multiple myeloma (MM) has significantly progressed in recent decades.
We analyzed the treatment patterns and clinical outcomes in Korean patients using data from the National Health Insurance Service database. Patients diagnosed with MM between 2010 and 2018 were included. Survival analysis with a Cox regression model was performed.
A total of 8,367 patients with MM were identified, from which 2,442 patients underwent stem cell transplantation (SCT). The mean patients' age at diagnosis was 67.1 years. Since 2011, the combination of a proteasome inhibitor (PI) and an alkylating agent has been most common, with a significant increase in the PI and immunomodulatory drug (IMiD) combination after 2015. The attrition rates after first-line therapy were 45% and 56% for the SCT and non-SCT groups, respectively. Patients on bortezomib, melphalan, and prednisolone were younger with less renal insufficiency compared to those on lenalidomide and dexamethasone. The SCT group had a median overall survival (OS) of 7.04 years, significantly higher than the non-SCT group's 2.52 years.
SCT eligibility and the reimbursement status of new drugs impact the treatment pattern of MM. Expanding access to new agents and identifying patients who can benefit from SCT are essential.
近几十年来，多发性骨髓瘤（MM）的治疗格局有了显著进展。
我们使用韩国国民健康保险服务数据库的数据，分析了韩国患者的治疗模式和临床结果。纳入了2010年至2018年间诊断为MM的患者。采用Cox回归模型进行生存分析。
共识别出8367例MM患者，其中2442例接受了干细胞移植（SCT）。患者诊断时的平均年龄为67.1岁。自2011年以来，蛋白酶体抑制剂（PI）与烷化剂联合使用最为常见，2015年后PI与免疫调节药物（IMiD）联合使用显著增加。一线治疗后，SCT组和非SCT组的损耗率分别为45%和56%。与接受来那度胺和地塞米松治疗的患者相比，接受硼替佐米、美法仑和泼尼松龙治疗的患者更年轻，肾功能不全的情况更少。SCT组的中位总生存期（OS）为7.04年，显著高于非SCT组的2.52年。
SCT的适用性和新药的报销状况影响MM的治疗模式。扩大新药的可及性并确定能从SCT中获益的患者至关重要。
