Evolution of Survival in Patients with Multiple Myeloma over Two Decades: A Real-World Experience from a Medium-Level...

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 (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).

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.