Observational study of multiple myeloma in Latin America.
Relatively little is known about the outcomes of multiple myeloma in Latin America, a world region where incorporation of novel agents is generally slow. In the current retrospective-prospective study, we aimed to describe the patterns of care and treatment results in five Latin American countries. Between April 2007 and October 2009, patients who had been diagnosed from January 2005 to December 2007 were registered at 23 institutions from Argentina, Brazil, Chile, Mexico, and Peru. We divided patients into two cohorts, according to transplantation eligibility, and analyzed them with regard to first-line treatment and overall survival (OS). We analyzed a total of 852 patients, 46.9 % of whom were female. The median follow-up was 62 months. Among transplantation-ineligible patients (N = 461), the mean age was 67.4 years, approximately one third of patients received a thalidomide-based treatment in the first line, and the median OS was 43.0 months. Transplantation-eligible patients (N = 391) had a mean age of 54.7 years and a median OS of 73.6 months. Autologous transplantation was performed in 58.6 % of the patients for whom this procedure was initially planned and in only 26.9 % of the overall patients. Our long-term results reflect the contemporary literature for patients with multiple myeloma treated with autologous transplantation and thalidomide-based regimens in clinical trials and observational studies. However, further efforts are needed to approve and incorporate novel agents in Latin American countries, as well as to increase access to transplantation, in order to achieve the expected improvements in patient outcomes.
Santa Casa Medical School, São Paulo, Brazil. hungria@dialdata.com.br.
Vania T M
VT
Hungria
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Angelo
A
Maiolino
Universidade de São Paulo, São Paulo, Brazil.
Gracia
G
Martinez
Universidade Estadual de Campinas, Campinas, Brazil.
Gislaine Oliveira
GO
Duarte
Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Rosane
R
Bittencourt
Centro de Pesquisas Oncológicas de Santa Catarina, Florianópolis, Brazil.
Lygia
L
Peters
Universidade Federal de São Paulo, São Paulo, Brazil.
Gisele
G
Colleoni
Medical School of Ribeirão Preto, Ribeirão Preto, Brazil.
Luciana C O
LC
Oliveira
Universidade Federal da Bahia, Salvador, Brazil.
Edvan
E
Crusoé
HEMOPE, Recife, Brazil.
Érika O D M
ÉO
Coelho
Universidade Federal do Paraná, Curitiba, Brazil.
Ricardo
R
Pasquini
Universidade Federal do Ceará, Fortaleza, Brazil.
Sílvia M M
SM
Magalhães
Hospital Brigadeiro, São Paulo, Brazil.
Renata
R
Nunes
Hospital de Base de Brasília, Distrito Federal, Brazil.
Jorge V Pinto
JV
Neto
Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Rosa Malena O
RM
Faria
Fundação Dr Amaral de Carvalho, Jaú, Brazil.
Mair
M
Souza
Hospital Albert Einstein, São Paulo, Brazil.
Nelson
N
Hamerschlak
Hospital Italiano, Buenos Aires, Argentina.
Dorotea
D
Flantl
Hospital Edgardo Rebagliati, Lima, Peru.
J R
JR
Navarro
Universidad de Chile, Santiago, Chile.
Guillermo
G
Conte
Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
David
D
Gomez-Almaguer
Centro de Hematologia y Medicina Interna de Puebla, Puebla, Mexico.
Guillermo
G
Ruiz-Argüelles
Inc. Cedar-Sinai Outpatient Cancer Center, Los Angeles, CA, USA.
Brian G M
BG
Durie
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012189:Retrospective Studies
Autologous; Multiple myeloma; Survival analysis; Thalidomide; Transplantation