Trends in survival of multiple myeloma: a thirty-year population-based study in a single institution.
BACKGROUND
Despite the progress made in recent years, multiple myeloma is still considered an incurable disease. Most survival data come from clinical trials. Little is known about the outcome in unselected real-life patients.


METHODS
Overall survival was analyzed in a cohort of newly diagnosed symptomatic multiple myeloma patients, over the last three decades, in a single institution population-based study.


RESULTS
582 consecutive myeloma patients were included in the study. Survival increased over time in patients younger than 65 years but did not reach statistical significance in patients with 65 years or older. The prognostic factors associated with overall survival were the International Staging System, the serum lactate dehydrogenase level, the renal impairment, the realization of autologous stem cell transplantation, and the presence of concomitant amyloidosis. Overall survival shows a steady improvement over time.


CONCLUSIONS
The survival of myeloma is improving progressively in real-life patients, particularly after the widespread use of the novel agents. A comprehensive assessment of comorbidity can help to explain the huge heterogeneity of myeloma outcome. The optimization of current therapeutic resources as well as the incorporation of new drugs will allow further improvement of survival in the coming years.
Monoclonal Gammopathies Unit, University Hospital Virgen de las Nieves, Granada, Spain; Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain; Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain. Electronic address: rriost33@gmail.com.
Rafael
R
Ríos-Tamayo
Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; CIBER Epidemiology and Public Health, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
María José
MJ
Sánchez
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
José Manuel
JM
Puerta
Monoclonal Gammopathies Unit, University Hospital Virgen de las Nieves, Granada, Spain; Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain; Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
Juan
J
Sáinz
Granada Cancer Registry, Andalusian School of Public Health, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
Daysi-Yoe-Ling
DY
Chang
Department of Inmunology, University Hospital Virgen de las Nieves, Granada, Spain.
Teresa
T
Rodríguez
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Pilar
P
López
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
José María
JM
de Pablos
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Pilar
P
Navarro
Department of Inmunology, University Hospital Virgen de las Nieves, Granada, Spain.
José Luís García
JL
de Veas
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Antonio
A
Romero
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Pilar
P
Garrido
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Lucía
L
Moratalla
Pharmacy Department, University Hospital Virgen de las Nieves, Granada, Spain.
Carolina
C
Alarcón-Payer
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Elisa
E
López-Fernández
Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain.
Pedro Antonio
PA
González
CIBER Epidemiology and Public Health, Granada, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
José Juan
JJ
Jiménez-Moleón
Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; Pharmacy Department, University Hospital Virgen de las Nieves, Granada, Spain.
Miguel Ángel
MÁ
Calleja-Hernández
Monoclonal Gammopathies Unit, University Hospital Virgen de las Nieves, Granada, Spain; Department of Hematology, University Hospital Virgen de las Nieves, Granada, Spain; Genomic Oncology Area, GENYO, Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
Manuel
M
Jurado
D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000639:trends*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy
Comorbidity; Multiple myeloma; Population-based registry; Survival