Survival, Years of Life Lost and Attrition Rates in Multiple Myeloma Patients in France.

Background: In a context of strong evolution of multiple myeloma (MM) treatment paradigm, real-world data allow a better understandingthe patients' medical needs.

Methods: The present analyses from the MYLORD study were designed to provide recent data on MM patients: characteristics, overall survival (OS), years of life lost (YLL) and attrition rates, using the French National Health Insurance Database (SNDS). It is based on a cohort of 33,032 MM patients who initiated a frontline therapy from 2014 to 2021 in France and who were followed until 2021.

Results: The 5-year OS rate is estimated at 51.9% (95% CI: 51.2-52.6). This rate is 78.3% (95% CI: 77.1-79.5) for patients with frontline autologous stem cell transplant (L1T) and 43.6% (95% CI: 42.8-44.4) for those without transplant (L1NT). The excess of mortality in MM patients is revealed by 12.3 YLL versus the matched general population and is higher in L1T patients than those L1NT (17 vs. 11 years). The attrition rate is important in MM patients with 38% of patients who did not benefit from at least 2 lines of treatment and is higher in L1NT patients than those in L1T (41% vs. 29%). Also, the majority of L1NT patients did not receive a L2 because of death, whereas it is because of stay in line status for L1T patients.

Conclusion: These results emphasize the urgency to treat MM patients with the best and tailored treatment strategy available, for all MM patients beneficiating or not from a transplant in frontline therapy. Further studies will be needed to assess the impact of new therapeutic options in real life.