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Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Shaji K. Kumar, MD
Prashant Kapoor, MD, FACP
Posted: Monday, September 18, 2023
Study results presented at the 2023 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract MM-074) and published in Clinical Lymphoma, Myeloma & Leukemia shed light on some surprising similarities and differences among outcomes of patients newly diagnosed with multiple myeloma in Lyon, France, or Oran, Algeria, who received a first-line treatment of induction followed by autologous stem cell transplantation (ASCT). Some did and some did not receive consolidation and maintenance, reported Mauricette Michaellet, MD, PhD, of Centre Léon Bérard, Lyon, France, and colleagues.
Although “these two countries [have] different resources and…nonidentical access to the same therapeutic arsenal and means of early detection of relapse,” the total population of patients in the two nations had similar global long-term overall survival, the team stated. This indicates that waiting to retreat patients with multiple myeloma, as often occurred in Algeria, can be correlated with a delayed time to next treatment—potentially supporting the hypothesis that waiting results in lower health-care costs and therapeutic savings.
Additionally, the patients in France and Algeria who did not relapse and received no chemotherapy after ASCT had similar rates of overall survival. In that category were two-thirds of the Algerian patients and one-third of the French patients, which is likely “explained by differences regarding the definition of relapse and leading to a probable underestimation in Algeria,” the authors stated.
To explore that observation further, they performed a survival analysis using the instant ratio. “We found better survival in France between 0 and 12 months after ASCT, related to higher nonrelapse mortality in Algeria,” they reported. Furthermore, survival after 48 months was higher in Algeria than in France, a result enhanced by a significant difference in the median time to next treatment in Algeria (72.6 months) and France (32.8 months).
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