Brazilian Real-Life Experience of Multiple Myeloma (MMyBRAve): Improvement in Outcomes, But Remaining Diagnostic and Therapeutic Gaps.

IF 2.7 4区 医学 Q2 HEMATOLOGY
Vania Hungria, Rosane Isabel Bittencourt, Gracia Aparecida Martinez, Juliana de Andrade Santos, Denise Ramos de Almeida, Vera Lucia de Piratininga Figueiredo, Danielle Leão Cordeiro de Farias, Karla Richter Zanella, Larissa Barchi Muniz, Juliana Tosta Senra, Rodrigo Martins Abreu, Éderson Roberto Mattos
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引用次数: 0

Abstract

Background: This study aimed at describing the demographic and clinical characteristics, treatment patterns and overall survival of patients with MM in Brazil to identify gaps in the disease diagnosis and treatment.

Methods: MMyBRAve (NCT03506386) was a multicenter, observational study of patients diagnosed with MM in Brazil between January 2008 and December 2016, with data collection between August 2018 and September 2019 at 17 participating centers.

Results: Of 943 patients included, 914 had complete data for overall survival (OS) analysis. The most used frontline regimens were cyclophosphamide, thalidomide and dexamethasone; bortezomib, cyclophosphamide and dexamethasone; and thalidomide and dexamethasone. After a median follow-up of 63 months, the median OS from diagnosis was 70 months. These results indicate continuous improvements in comparison with previous observational studies from Brazil. The median OS in transplantation-ineligible (N = 491) and eligible (N = 452) patients were 49 and 93 months, respectively (hazard ratio [HR] = 0.52; 95% confidence interval [CI], 0.43 to 0.63; P < .001). The median OS also differed between patients with and without known prognostic factors.

Conclusion: Despite the improvements, our results suggest that access to novel agents and transplantation continue to hinder further progress in patient outcomes in Brazil and countries with similar health-care constraints.

巴西多发性骨髓瘤真实生活经验(MMyBRAve):结果有所改善,但诊断和治疗仍有差距。
背景本研究旨在描述巴西MM患者的人口统计学和临床特征、治疗模式和总生存率,以找出疾病诊断和治疗方面的差距:MMyBRAve(NCT03506386)是一项多中心观察性研究,研究对象为2008年1月至2016年12月期间在巴西确诊的MM患者,数据收集工作于2018年8月至2019年9月在17个参与中心进行:在纳入的943名患者中,有914名患者的数据完整,可用于总生存期(OS)分析。最常用的一线治疗方案为环磷酰胺、沙利度胺和地塞米松;硼替佐米、环磷酰胺和地塞米松;沙利度胺和地塞米松。中位随访期为63个月,自确诊起的中位OS为70个月。这些结果表明,与巴西以往的观察性研究相比,该研究的结果不断改善。不符合移植条件的患者(N = 491)和符合移植条件的患者(N = 452)的中位OS分别为49个月和93个月(危险比[HR] = 0.52;95%置信区间[CI],0.43至0.63;P < .001)。具有和不具有已知预后因素的患者的中位OS也有所不同:结论:尽管情况有所改善,但我们的研究结果表明,在巴西和医疗条件相似的国家,新型药物的使用和移植仍然阻碍着患者预后的进一步改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.70
自引率
3.70%
发文量
1606
审稿时长
26 days
期刊介绍: Clinical Lymphoma, Myeloma & Leukemia is a peer-reviewed monthly journal that publishes original articles describing various aspects of clinical and translational research of lymphoma, myeloma and leukemia. Clinical Lymphoma, Myeloma & Leukemia is devoted to articles on detection, diagnosis, prevention, and treatment of lymphoma, myeloma, leukemia and related disorders including macroglobulinemia, amyloidosis, and plasma-cell dyscrasias. The main emphasis is on recent scientific developments in all areas related to lymphoma, myeloma and leukemia. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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