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An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Changes in survival rate of multiple myeloma after the introduction of bortezomib: a single institutional
Manabu Fujisawa1, Yasuhito Suehara1, Kota Fukumoto1
1Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, 929 Higashi-chou, Kamogawa-shi, Chiba, 296-8602, Japan.
Abstract:
The data of factors on the changes in survival before and after the introduction of bortezomib in unselected multiple myeloma (MM) patients is scarce in Asian population. We analyzed the clinical features and treatment outcomes of 270 consecutive MM patients admitted to our hospital between January 1995 and August 2014. The patients were divided into two groups, 1995–2005 (n=106) and 2006–2014 (n=164), based on bortezomib availability. There were no differences in baseline characteristics between the groups, except age and percentage of patients receiving autologous stem cell transplantation (auto-SCT). The proportion of patients obtaining ≥very good partial response (VGPR) was higher in the recent cohort, which was translated as better overall survival in both younger and older patients (36.1 vs. 79.8 months, P=0.024, and 40.0 vs. 110.7 months, respectively). Patients receiving bortezomib early after diagnosis showed significantly better survival. However, there was no difference in survival between patients obtaining ≥VGPR in the two groups. On multivariate analysis, age ≥75 and lactate dehydrogenase (LDH) >normal were associated with shorter survival, while early bortezomib use and auto-SCT were associated with longer survival. On Cox regression analysis, International Staging System (ISS) stage III, LDH, and treatment response
Insights
Bortezomib introduction significantly improved survival for multiple myeloma (MM) patients in Japan. Early treatment and autologous stem cell transplantation (auto-SCT) were key factors for better outcomes.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Data on survival changes after bortezomib introduction in Asian multiple myeloma (MM) patients is limited.
- Understanding treatment impacts in diverse populations is crucial for refining MM management.
Purpose of the Study:
- To analyze clinical features and survival outcomes of MM patients before and after bortezomib availability in Japan.
- To identify factors influencing survival in MM patients treated with and without bortezomib.
Main Methods:
- Retrospective analysis of 270 MM patients from January 1995 to August 2014.
- Patients divided into two cohorts: 1995–2005 (pre-bortezomib) and 2006–2014 (post-bortezomib availability).
- Comparison of baseline characteristics, treatment responses (≥very good partial response - VGPR), and survival rates between cohorts.
Main Results:
- The recent cohort (2006–2014) showed a higher proportion of patients achieving ≥VGPR, correlating with improved overall survival (36.1 vs. 79.8 months and 40.0 vs. 110.7 months).
- Early bortezomib use and autologous stem cell transplantation (auto-SCT) were associated with significantly longer survival.
- Multivariate analysis identified age ≥75, elevated lactate dehydrogenase (LDH), and International Staging System (ISS) stage III as negative prognostic factors, while early bortezomib and auto-SCT were positive predictors.
Conclusions:
- Bortezomib availability in Japan led to a marked improvement in MM patient survival from 2006–2014.
- Early intervention with bortezomib and auto-SCT are critical for enhancing survival in multiple myeloma.
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