{'fraction_non_alphanumeric': 0.034805194805194804, 'fraction_numerical': 0.023376623376623377, 'mean_word_length': 5.094936708860759, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Treatment outcome of newly diagnosed multiple myeloma patients: A retrospective analysis in a resource-limited setting

Multiple myeloma is the third most common hematologic malignancy in
Malaysia. The introduction of novel agents over the past decades has
improved patient outcome and survival substantially. The usage of novel
agents can be financially taxing, and hence resources limit its use.
This study aims to report on the real-world treatment outcome when
resources are limited. This is a retrospective study on newly diagnosed
multiple myeloma (NDMM) patients diagnosed between 1 January 2008 and 31
December 2018 in a single academic center. Patients demographic and type
of treatment were included for analysis of progression free survival and
overall survival. Ninety-eight NDMM patients with a median age of 63.5
(ranged from 38 to 87 years old) were included. Half of the total
patients received bortezomib-containing regimens while 40.8% received
thalidomide-containing regimens, and remaining 9.2% had other agents as
induction. Forty-seven patients (48.0%) achieved very good partial
response (VGPR) or complete remission (CR), while remaining 51 patients
(52.0%) have achieved partial response (PR) at best during induction
therapy. Bortezomib use was associated with significantly deeper
(p=0.001) and more rapid response (p=0.005) compared to other agents.
Five-year OS and PFS were 45.3% and 18.4%, respectively. Triplet
regimen, best initial response and upfront ASCT were significantly
associated with better PFS. In conclusion, deep response significantly
affects PFS and OS in NDMM patients. Thus, one of the goals of treatment
is to ensure earlier and deeper response by including bortezomib as part
of triplet combination in upfront therapy, followed by ASCT for those
who are fit. This is feasible in a resource limited country such as
Malaysia, especially there is a cheaper generic formulation.