TY - JOUR
T1 - Defining cure in multiple myeloma
T2 - A comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies
AU - Ravi, Praful
AU - Kumar, Shaji K.
AU - Cerhan, James R.
AU - Maurer, Matthew J.
AU - Dingli, David
AU - Ansell, Stephen M.
AU - Rajkumar, S. Vincent
N1 - Publisher Copyright:
© 2018 The Author(s).
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients (≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included. Observed vs. expected survival was summarized by standardized mortality ratios (SMR). Compared to the background US population, excess mortality risk was seen at diagnosis in all four cancers, SMR 19.5 (15.2-24.5) in MM, 4.2 (2.3-7.2) in FL, 13.0 (9.2-18.4) in DLBCL, and 5.2 (2.6-9.3) in HL. We reasoned that cure would most likely occur in the first 3 years after diagnosis and be reflected by an overall survival probability similar to the background population. From the 36-month landmark, excess mortality risk was seen in MM (SMR 20.7 [14.7-28.3]) and FL (SMR 3.8 [1.5-7.8]), but not with DLBCL (SMR 3.1 [0.8-8.0]) or HL (SMR 0.9 [0.0-5.1]). MM patients have 20-fold excess mortality risk compared to the background population at diagnosis and at 3 years after diagnosis, suggesting that MM remains an incurable cancer.
AB - Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients (≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included. Observed vs. expected survival was summarized by standardized mortality ratios (SMR). Compared to the background US population, excess mortality risk was seen at diagnosis in all four cancers, SMR 19.5 (15.2-24.5) in MM, 4.2 (2.3-7.2) in FL, 13.0 (9.2-18.4) in DLBCL, and 5.2 (2.6-9.3) in HL. We reasoned that cure would most likely occur in the first 3 years after diagnosis and be reflected by an overall survival probability similar to the background population. From the 36-month landmark, excess mortality risk was seen in MM (SMR 20.7 [14.7-28.3]) and FL (SMR 3.8 [1.5-7.8]), but not with DLBCL (SMR 3.1 [0.8-8.0]) or HL (SMR 0.9 [0.0-5.1]). MM patients have 20-fold excess mortality risk compared to the background population at diagnosis and at 3 years after diagnosis, suggesting that MM remains an incurable cancer.
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U2 - 10.1038/s41408-018-0065-8
DO - 10.1038/s41408-018-0065-8
M3 - Article
C2 - 29531285
AN - SCOPUS:85044244882
SN - 2044-5385
VL - 8
JO - Blood cancer journal
JF - Blood cancer journal
IS - 3
M1 - 26
ER -