The regional register of multiple myeloma: significance in the era of new drugs

Introduction. Trend of improving life expectancy of patients with multiple myeloma (MM) is observed from the second half of the 2000s. The changes occur in the general population of patients with MM for a certain period of the time when emerge new drugs and regimes with them. These changes have a great practical interest in this connection. Material and methods. The material of our study was the data of registration of the all cases of multiple myeloma in 2007-2015 period (n=193). In 2007-2008 some patients began to receive first-line regimes including bortezomib, but after a few Alkeran-containing cycles (MP, VCMP, etc.) due to the availability of bortezomib. Results. Complete remission (CR) and very good partial remission (VGPR) rates were lower in the group of patients who received bortezomib than in the group of patients who received induction therapy PAD - 5 (19%) vs 26 (58%) cases respectively (p=0.01). VMP regime demonstrated high efficacy in the absence of restrictions to prescribe Alkeran in the second line - CR and VGPR - 68% (13 cases). The distribution by stages ISS: I - 42 (23%), II - 64 (34%), III - 81 (43%). Renal failure (RF) was detected in 48 patients (26%). 5-year overall survival (OS) was 58% in the population, 10-year - was 20%, the median OS was 84 months (7 years). The detection of the parameters, which have a negative effect on the duration of the OS, was the result of univariate study. Such factors as the presence of renal failure, the need for hemodialysis, the disease stage and male sex stand out from among them. Multivariate Cox regression analysis identified the independent value of renal failure at the onset of the disease, III stage of disease according to ISS and resistance/progression with the first-line therapy in the adverse factors for OS. Conclusions. An analysis of registration data allows to update some of the factors as the most unfavorable and non-levelling with new drugs using, and at the same time to revise the value of the other factors. Population registers allow to identify accurately the size and characteristics of the groups of patients which are in need of new therapies.

multiple myeloma, population registers, proteasome inhibitors, immunomodulators, risk factors