The Myeloma Landscape in Australia and New Zealand: The First 8 Years of the Myeloma and Related Diseases Registry (MRDR) |
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| Authors: | Krystal Bergin Cameron Wellard Elizabeth Moore Zoe McQuilten Hilary Blacklock Simon J Harrison P Joy Ho Tracy King Hang Quach Peter Mollee Patricia Walker Erica Wood Andrew Spencer |
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| Institution: | 1. Department of Haematology, Alfred Health–Monash University, Melbourne, Victoria, Australia;2. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;3. Clinical Haematology, Middlemore Hospital, Middlemore, Auckland, New Zealand;4. Clinical Haematology, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia;5. Sir Peter MacCallum Department of Oncology, Melbourne University, Parkville, Melbourne, Victoria, Australia;6. Clinical Haematology, Royal Melbourne Hospital, Melbourne, Victoria, Australia;7. Royal Prince Alfred Hospital, Camperdown, and University of Sydney, Sydney, New South Wales, Australia;8. Clinical Haematology, University of Melbourne and St Vincent’s Hospital, Melbourne, Victoria, Australia;9. Clinical Haematology, Princess Alexandra Hospital and University of Queensland, Brisbane, Queensland, Australia;10. Clinical Haematology, Peninsula Health, Frankston, Victoria, Australia;1. Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;2. Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;1. Department of Haematology, Epworth HealthCare, Melbourne, Victoria, Australia;2. Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia;3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Victoria, Australia;4. Department of Haematology, Royal Melbourne Hospital, Melbourne, Victoria, Australia;1. Department of Pharmacy, College of Pharmacy, Seoul National University, Seoul, Korea;2. Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Korea;3. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea;4. Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea;5. Dongsan Medical Center, Keimyung University, Daegu, Korea;6. Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea;7. Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea;8. Department of Hematology, Catholic Hematology Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea;2. St. John of God Hospital Subiaco, Perth, Western Australia |
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| Abstract: | BackgroundReal-world multiple myeloma (MM) data are scarce, with most data originating from clinical trials. The Myeloma and Related Diseases Registry (MRDR) is a prospective clinical-quality registry of newly diagnosed cases of plasma cell disorders established in 2012 and operating at 44 sites in Australia and New Zealand as of April 2020.MethodsWe reviewed all patients enrolled onto the MRDR between June 2012 and April 2020. Baseline characteristics, treatment, and outcome data were reviewed for MM patients with comparisons made by chi-square tests (categorical variables) and rank sum tests (continuous variables). Kaplan-Meier analysis was used to estimate progression-free survival and overall survival (OS).ResultsAs of April 2020, a total of 2405 MM patients were enrolled (median age, 67 years, with 40% aged > 70 years). High-risk features were present in 13% to 31% of patients: fluorescence in-situ hybridization (FISH) ≥ 1 of t(4;14), t(14;16), or del(17p) 18%, International Staging System (ISS)-3 31%, and Revised ISS (R-ISS)-3 13%. Cytogenetic/FISH analyses were performed in 50% and 68% of patients, respectively, with an abnormal karyotype result in 34%. Bortezomib-containing therapy was the most common first-line therapy (79.3%, n = 1706). Patients not receiving bortezomib were older (median age, 76 vs 65 years, P < .001) with inferior performance status (Eastern Cooperative Oncology Group performance status ≥ 2, 41% vs 18%, P < .001). Median progression-free survival and OS were 30.8 and 65.8 months, respectively. Younger patients had superior OS (76.3 vs 46.7 months, P < .001, < 70 and ≥ 70 years, respectively). R-ISS score was available in 50.7% (n = 1220) of patients, and higher R-ISS was associated with inferior OS (R-ISS-1 vs R-ISS-2 vs R-ISS-3: not reached vs 68.1 months vs 33.2 months, respectively, P < .001).ConclusionClinical registries provide a more complete picture of MM diagnosis and treatment, and highlight the challenges of adhering to best practices in a real-world context. |
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| Keywords: | Autologous transplantation Diagnosis Multiple myeloma Real world Therapy |
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