Abstract: PB1974
Type: Publication Only
Background
The Granada Myeloma Registry is the second largest single-institution population-based registry (Ríos-Tamayo et al, 2015) of multiple myeloma (MM) referenced to date. Here we update and point out the epidemiological variables of interest.
Aims
To highlight the importance of the epidemiological perspective in the knowledge and outcome of MM
Methods
From January 1985 to February 2017 all consecutive patients diagnosed with MM at our institution have been registered, including clinical, biological and socio-demographic variables, as previously reported. A comprehensive approach to comorbidity was recorded as well as diagnostic and treatment delay. Overall survival (OS) was estimated by the Kaplan-Meier method.
Results
700 patients have been included in the registry, 343 men (49%) and 357 women. All cases have their place of residence in the Granada province. The median age was 67 years (range: 12-93). The race was Caucasian in 98.9%. In relation to occupation, 18.4% were skilled or elementary agricultural workers.
Only 9% had a previously documented precursor disease (solitary plasmacytoma,
monoclonal gammopathy of undetermined significance, or smoldering MM), and 14 patients (2%) remain alive with smoldering MM without progression.
The subtype of MM is IgG 55.6%, IgA 24.8%, Light chain Only 15.9%, Non-secretory 3%, IgD 0.6% and IgM 0.2%. The International Staging System is known in 378 patients: 1 (25.9%), 2 (25.7%), and 3 (48.4%). Baseline performance status (ECOG) was: 0 (4.7%), 1 (41.1%), 2 (26.7%), 3 (21.7%), and 4 (5.9%).
Comorbidity was assessed in 498 patients. 30.6% of patients were obese at the moment of diagnosis. 8.2% had other previously known or synchronous neoplasm. 150 patients (30.1%) had three or more comorbidities.
Median diagnostic delay was 4.1 months (0.1-80) and median treatment delay was 13 days.
44 patients (6.3%) were very unfit and they did not receive active treatment. Information about stem cell transplant is available in 606 cases: 151 of them (24.9%) received a first autologous transplant.
Median OS for the whole cohort was 43.1 and 22.4 months for patients younger than 65 years or 65 years and older, respectively (p <0.001). For patients diagnosed in 2010 or later, median OS is not reached for younger than 65 and 40.4 months for the elderly (p=0.001). Information about the main cause of dead is available in 230 patients: 101 (43.9%) of them died by infection.
Conclusion
MM is a very heterogeneous disease from a clinical, biological and epidemiological perspective. The distribution by sex is identical. Farmer is the most frequent occupation. Almost one in three patients are obese, and one in ten had another prior or associated neoplasm. Infection is the leading cause of death. Information derived from population-based registries may help to complement data from clinical trials.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
