title: Survival of myeloma patients following the introduction of thalidomide as a second-line therapy: a retrospective study at a single New Zealand centre.
abstract: OBJECTIVE
  This retrospective study compares the overall survival (OS) of multiple myeloma (MM) patients following treatment at a New Zealand hospital over a period in which novel therapies were available but restricted, almost exclusively, to thalidomide as a second-line therapy.
  
  
  METHODS
  Clinical, laboratory and OS data were collected on 361 MM patients who were treated at Christchurch Hospital during 2000-2010. Patients were subdivided according to the clinical criteria used to determine front-line treatment decisions. Older patients (age ≥66, n = 180) generally received standard-dose chemotherapy without autologous stem cell transplant (SCT) and formed one group. Younger patients were further subdivided according to whether they received autologous SCT (n = 89), allogeneic SCT (n = 24) or no SCT (n = 68).
  
  
  RESULTS
  Older patients had a significantly shorter OS (P < 0.0001) than younger patients (median OS = 25 vs 78 months) however treated. Analysis of relative survival demonstrated that the increased mortality of older patients was greater than that attributable to normal ageing. Younger patients who received no transplant had a significantly shorter OS (P < 0.0001) than those who received autologous SCT or allogeneic SCT with 5-year survivals of 38%, 70% and 72% respectively. Use of novel therapies was significantly higher in younger than older patients (60% vs 47%, P = 0.011).
  
  
  CONCLUSIONS
  The front-line treatment groupings of hospital MM patients had significantly different survivals. The OS of SCT ineligible patients remains poor despite the introduction of thalidomide.
authors.affiliation: Department of Pathology, University of Otago at Christchurch, Christchurch, New Zealand.
authors.forename: L J
authors.initials: LJ
authors.lastname: Fernyhough
authors.forename: B D
authors.initials: BD
authors.lastname: Hock
authors.forename: J
authors.initials: J
authors.lastname: Taylor
authors.forename: J
authors.initials: J
authors.lastname: Pearson
authors.forename: P
authors.initials: P
authors.lastname: Ganly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy*; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality* / Q000639:trends; D015996:Survival Rate / Q000639:trends; D013792:Thalidomide / Q000008:administration & dosage*; D019172:Transplantation Conditioning / Q000401:mortality* / Q000639:trends; D014182:Transplantation, Autologous / Q000401:mortality / Q000639:trends; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide