Ortega-Vida Esther, Rosado-Rodriguez Abel, Fe Rocio, Verdugo Victoria, Gavira Rocio, Garzón Sebastián
Department of Hematology, University Hospital of Jerez, 11407 Jerez de la Frontera, Spain.
Department of Pharmacy, University Hospital of Jerez, 11407 Jerez de la Frontera, Spain.
Cancers (Basel). 2025 Feb 25;17(5):793. doi: 10.3390/cancers17050793.
The gradual introduction of numerous therapeutic advancements over recent years in the treatment of patients with multiple myeloma (MM) appears to have contributed to significant improvements in overall survival (OS).
We conducted a single-center retrospective observational study, including all MM patients treated at the University Hospital of Jerez de la Frontera, diagnosed between 1 January 2000, and 31 December 2022. Patients were divided into three calendar periods (2000-2007, 2008-2015, and 2016-2022) and two patient groups (candidates and non-candidates for autologous hematopoietic progenitor transplantation).
A total of 420 myeloma patients were included in this study, with a median age of 64 years. The median survival steadily improved from 50.7 months (33.8-73.2; 95% CI) in 2000-2007 to 72.4 months (57.5-98.2; 95% CI) in 2008-2015 and has not yet been determined in the 2016-2022 cohort ( = 0.008). OS improved in all age groups, even in older patients. The median OS in patients not undergoing autologous stem cell transplantation (ASCT) was 38.8 months (31.5-51.6; 95% CI) compared with 132.66 months (110.5-150.9; 95% CI) in those who underwent this procedure ( < 0.0001). The introduction of novel drug classes in first-line treatment significantly improved OS compared with traditional chemotherapy (56.7 months). The median OS increased to 78.8 months (95% CI: 68.8-113.3; = 0.03) with proteasome inhibitors (PIs), 99.4 months (95% CI: 99.4-NA; < 0.0001) with immunomodulatory drugs (IMIDs), and was not determined for anti-CD38 monoclonal antibodies ( = 0.02).
Survival outcomes for MM have significantly improved over the past two decades, particularly among younger and ASCT-eligible patients. However, according to all studies, disparities persist across healthcare settings, underscoring the need for equitable access to modern therapies and optimized management strategies.
近年来，多种治疗进展在多发性骨髓瘤（MM）患者治疗中的逐步引入似乎促使总生存期（OS）有了显著改善。
我们开展了一项单中心回顾性观察研究，纳入了2000年1月1日至2022年12月31日期间在赫雷斯-德拉弗龙特拉大学医院确诊并接受治疗的所有MM患者。患者被分为三个日历时间段（2000 - 2007年、2008 - 2015年和2016 - 2022年）以及两个患者组（自体造血干细胞移植候选者和非候选者）。
本研究共纳入420例骨髓瘤患者，中位年龄为64岁。中位生存期从2000 - 2007年的50.7个月（33.8 - 73.2；95%CI）稳步提高到2008 - 2015年的72.4个月（57.5 - 98.2；95%CI），2016 - 2022年队列的中位生存期尚未确定（P = 0.008）。所有年龄组的OS均有所改善，老年患者也是如此。未接受自体干细胞移植（ASCT）的患者中位OS为38.8个月（31.5 - 51.6；95%CI），而接受该治疗的患者中位OS为132.66个月（110.5 - 150.9；95%CI）（P < 0.0001）。与传统化疗（56.7个月）相比，一线治疗中新型药物类别的引入显著改善了OS。蛋白酶体抑制剂（PIs）使中位OS增至78.8个月（95%CI：68.8 - 113.3；P = 0.03），免疫调节药物（IMIDs）使中位OS增至99.4个月（95%CI：99.4 - NA；P < 0.0001），抗CD38单克隆抗体的中位OS尚未确定（P = 0.02）。
在过去二十年中，MM的生存结局有了显著改善，尤其是在年轻患者和适合ASCT的患者中。然而，根据所有研究，不同医疗环境之间的差异仍然存在，这突出表明需要公平获得现代疗法和优化管理策略。
