Background: 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). Methods: 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). Results: 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 (p= 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 (p< 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;p= 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 (p= 0.02). Conclusions: 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.
背景：近年来，多发性骨髓瘤（MM）治疗领域逐步引入的多种治疗进展，似乎显著改善了患者的总体生存期（OS）。方法：我们开展了一项单中心回顾性观察研究，纳入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接受治疗的所有MM患者。将患者按日历时间分为三个时期（2000–2007年、2008–2015年和2016–2022年），并按是否适合接受自体造血祖细胞移植分为两组。结果：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年间的50.7个月（95% CI：33.8–73.2）稳步提升至2008–2015年间的72.4个月（95% CI：57.5–98.2），而2016–2022年队列的中位生存期尚未达到（p=0.008）。所有年龄组患者的OS均有所改善，即使是老年患者也不例外。未接受自体干细胞移植（ASCT）的患者中位OS为38.8个月（95% CI：31.5–51.6），而接受该治疗的患者中位OS为132.66个月（95% CI：110.5–150.9）（p<0.0001）。与传统化疗（56.7个月）相比，一线治疗中引入新型药物类别显著改善了OS。使用蛋白酶体抑制剂（PIs）时，中位OS提高至78.8个月（95% CI：68.8–113.3；p=0.03）；使用免疫调节药物（IMIDs）时，中位OS提高至99.4个月（95% CI：99.4–未达到；p<0.0001）；而抗CD38单克隆抗体的中位OS尚未确定（p=0.02）。结论：过去二十年间，MM的生存结局显著改善，尤其是在年轻和适合ASCT的患者中。然而，所有研究均表明，不同医疗环境下的生存差异依然存在，这凸显了公平获取现代疗法和优化管理策略的必要性。
肿瘤(癌症)患者之家