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Survival of 1,103 Chilean patients with multiple myeloma receiving different therapeutic protocols from 2000 to 2016 Background: Multiple myeloma (MM) is one of the most common malignancies found in hematology. Aim: To describe the features of patients with MM and perform a survival analysis according to the different treatment protocols used between 2000 and 2016. Material and Methods: Analysis of the database of the Chilean national anti-neoplastic drug program. Information was obtained from 1,103 patients, with a median age of 64.5 years (range 27-95) and a male to female ratio of 1:1.2. Results: The mean overall survival (OS) of patients receiving or not receiving Thalidomide was 46 and 30 months, respectively (p < 0.01). The mean OS of patients treated before 2007 (treated with melphalan and prednisone) and between 2007 and 2012 (treated with thalidomide and dexamethasone) was 36 and 48 months respectively. In the group starting in 2013 (treated with cyclophosphamide, thalidomide and dexamethasone) the median survival had not been reached at 20 months of follow up (p = 0.01 for all comparisons). Autologous transplantation (AT) was carried out in only 18% of the eligible patients. The median OS of the patients who receive an AT had not been reached at 48 month compared with 36 month among those who did not received the procedure (p < 0.01). Conclusions: Even though overall survival has improved with time, new drugs must be introduced in our protocols to obtain similar results to those obtained worldwide.

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PURPOSE Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma subtype. The purpose of this study was to evaluate the clinical features, prognostic factors, and results of DLBCL that was treated in the cancer centers of the public health system in Chile and compare cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). PATIENTS AND METHODS Patients age > 15 years who were treated in 18 cancer centers in the country between 2001 and 2017 were included. The Kaplan-Meier method was used to calculate overall survival (OS), and Cox proportional hazard regression modeling was used to evaluate the effect of the addition of rituximab to CHOP on OS. RESULTS A total of 1,807 patients were evaluated. The median age at diagnosis was 62 (range, 15-95) years, with a female predominance (53%). Half of the patients were age ≥ 60 years. Serology for HIV infection was positive in 5% of cases (96 cases). International Prognostic Index scores were available for 90% of patients, of which 45% had low-risk, 25% low-intermediate-risk, 18% high-intermediate-risk, and 11% high-risk scores. CHOP was administered to 986 patients (55%; median follow-up, 13.2 years) and R-CHOP to 821 patients (45%; median follow-up, 8.4 years). R-CHOP was associated with superior OS compared with CHOP (5-year 66% v 48%, and 10-year 53% v 35%; P < .001). CONCLUSION Rituximab improved the survival of patients with DLBCL diagnosed and treated in Chile. The benefit was sustained over time, with curative rates of > 50%. This intervention shows that the inclusion of this biological drug justified the expenses incurred by the Ministry of Health in the National Lymphoma Protocols in Chile.

There is no data about the prognosis of patients with MM in Chile, except mortality rate records. The objective of this study is to know the clinical features, survival rates and factors related to early mortality of cases with MM treated in six large medical centers in Chile. Method: Retrospective demographic data, clinical features and survival rate records of patients with MM were collected between 1998 and 2002. Survival curves were generated and a multivariate analysis of factors associated to early mortality was carried out. Results: Data of 245 patients was collected. A 51.8% of them corresponded to IgG myeloma, 25.3% to IgA and a 6.1% to light chains. Distribution according Durie and Salmon was: Stage I: 8.1%; Stage II: 12.7%; Stage III: 60.7% and 18.4% without information. It is pointed out that, among clinical features, a 50% of the cases presented anemia (Hb &lt;10gr/dL), a 30% renal failure (creatininemia &gt;2 mg/dL) and a 28% hypercalcemia (&gt;10.5 mg/dL). The median survival was 33 months. A 20% of patients died within the six first months after diagnosis. The multivariate analysis identified three factors associated to early mortality (survival &lt;6 months): males (p=0.016), beta2-microglobulin &gt;3.5 mg/L (p=0.021) and albuminemia &lt; 3.5 gr/dL (p=0.016). Conclusions: It was observed that, in Chilean population, patients with MM presented a short survival time, and a significative proportion of patients (20%) died within the first six months after the first diagnosis. More than a half of cases were diagnosed at an advanced stage. (Durie and Salmon: Stage III). Three factors associated to early mortality, two of which (beta2-microglobulin and albuminemia) are the foundations of the new international staging system, might be identified.