Artículo de revista
Survival differences in multiple myeloma in Latin America and Asia: a comparison involving 3664 patients from regional registries
Fecha
2019Registro en:
Annals of Hematology (2019) 98:941–949
14320584
09395555
10.1007/s00277-019-03602-4
Autor
Hungría, Vania T. M.
Lee, Jae Hoon
Maiolino, Angelo
de Queiroz Crusoe, Edvan
Martínez, Gracia
Bittencourt, Rosane
Oliveira Duarte, Gislaine
Fantl, Dorotea Beatriz
Navarro, Juan Ramón
Conte, Guillermo
Gómez Almaguer, David
Ruiz Argüelles, Guillermo J.
Kim, Kihyun
Shimizu, Kazuyuki
Chen, Wenming
Shang, Shang-YI
Chng, Wee-Joo
Chim, Chor Sang
Nawarawong, Weerasak
Durie, Brian
Institución
Resumen
In previous observational studies, we have separately characterized patients with multiple myeloma (MM) both from Latin America (LA) and from Asia. Here, we analyze these two datasets jointly, in order to assess the overall survival (OS) in these two world regions. Data were available from 3664 patients (1968 from LA and 1696 from Asia); all of whom diagnosed between 1998 and 2007. Approximately, 26% of patients in both world regions underwent transplantation. OS (from diagnosis of MM) was explored with Kaplan–Meier analyses and Cox proportional hazards models. Patients from LA were significantly younger and had hypercalcemia more often than Asian patients, who in turn had higher proportions of anemia and International Staging System (ISS) stage III disease. The median OS was 56 months in LA, and 47 months in Asia (hazard ratio [HR] = 0.83; 95% confidence interval [CI], 0.76 to 0.91; P < 0.001). In multivariable analysis, age, ISS stage III, anemia, hypercalcemia, and world region remained significantly associated with OS (P < 0.001 for all covariates). These results were largely driven by patients not undergoing transplantation, as no difference in OS emerged between the two world regions in univariable or multivariable analysis for transplanted patients. Despite adverse prognostic features differentially favoring each region, and adjusting for such differences, we found an OS advantage for patients from LA, in comparison with contemporaneous patients from Asia. Whether this is due to different biological features, differences in access to novel agents (especially thalidomide in earlier periods of the study), unmeasured confounders, or the play of chance, remain unknown.