Multiple myeloma: Experience of an institute in limited resource setting

Jacob, Linu Abraham; Babu, M C Suresh; Lakshmaiah, K C; Babu, K. Govind; Dasappa, Lokanatha; Rajeev, L K; Lokesh, K N; Rudresha, A H; Agarwal, Ankit; Garg, Sunny

doi:10.4103/ijc.ijc_87_17

Cited by 14 publications

(13 citation statements)

References 8 publications

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“…In our study, patients received VAD (vincristine, adriamycine, dexamethason) regimen for six cycles and thalidomide for maintenance therapy. It was similar to the study that was reported by Jacob et al [ 14 ] with result of median survival for the ISS stage I, ISS stage II, and ISS stage III groups was 48 months, 21 and 27 months respectively and it was also lower than our study. If our study was compared to the Western data, where the 5-year survival post-transplant ASCT for ISS I, ISS II, and ISS III was 82%, 62%, and 40%, respectively [ 28 ].…”

Section: Discussionsupporting

confidence: 92%

“…Multiple myeloma has a male predominance [ 13 ], with median age 54 years (range 39–85) [ 14 ]; with the most common presenting symptoms were pain, impending/pathological fracture, anemia, and neurological deficit [ 6 ]. It is consistent with our study which showed that 18 male and 14 female with median age was 59 years (range 43–79).…”

Section: Discussionmentioning

confidence: 99%

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Survival rate of multiple myeloma patients in Indonesia: A retrospective study in multiple myeloma at a single institution

Andriandi

Kamal

2019

Annals of Medicine and Surgery

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Introduction To evaluate the response and the correlation between survival and prognostic factors in 32 patients with multiple myeloma. Method We recruited 32 patients (18 men and 14 women) with mean age 59 years old who were diagnosed with multiple myeloma that were treated with surgery (n = 21) and without surgery (n = 11). 9 patients underwent hemiarthroplasty, 14 patients underwent open reduction and internal fixation and 4 patients underwent spinal decompression and posterior pedicular instrumentation from January 2012 to December 2017. In this group, there were 6 patients who underwent more than one surgeries. Patients were classified using the International Staging System (ISS) for multiple myeloma by evaluated albumin and β 2 -microglobulin level. Results The mean follow up period for 32 patients was 30.2 months (range, 3–65 months) with 7 patients in ISS stage I, 22 patients in ISS stage II and 3 patients in ISS stage III. The median survival duration was 28 months (95% CI). We documented the median survival for ISS stage II disease was 29 months, stage III disease 6 months and stage I disease 16 months with the median age of ISS stage I, II, and III disease was 65, 59, 60 years respectively. Survival correlation with ISS stage (p = 0.009), the hemoglobin level (p = 0.772), and the calcium level (p = 0.926). Conclusions The survival rate was lower in patients with higher ISS stage for this disease. Survival rate seems to be better among younger patients than in older ones even with lower ISS stage of this disease.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Survival rate of multiple myeloma patients in Indonesia: A retrospective study in multiple myeloma at a single institution

Andriandi

Kamal

2019

Annals of Medicine and Surgery

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“…In our study, 49 (41.88%) patients were staged ISS-III which was more compared to other Indian study by Jacob LA et al (2017) and western studies by Greipp PR et al (2005) and Attal M et al (2015) where frequency of ISS-III was 39%, 39% and 18% respectively (21,6,22).…”

Section: Discussioncontrasting

confidence: 51%

Cytogenetics and Revised International Staging System (R-ISS): Risk Stratification in Multiple myeloma - A Retrospective Study in Indian Population

Udupa

Pai

et al. 2020

Iran J Pathol

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Scan to discover online Background & Objective: Cytogenetic abnormalities in Multiple myeloma (MM) has emerged as the most important factor that determine the prognosis and survival. Fluorescence in situ hybridization (FISH) can detect a greater number of cytogenetic abnormalities as compared to conventional karyotyping and hence has become the standard test in determining genetic abnormalities in MM. The present study was planned as there is an unmet need to find out various cytogenetic abnormalities and to implement them in prognostic stratification by Revised International Staging System (R-ISS) among Indian population. Methods: A single institution retrospective study was conducted among a total of 117 patients newly diagnosed as Multiple Myeloma. They were analyzed for various cytogenetic abnormalities by using interphase FISH (iFISH) and were staged according to Revised International Staging System (R-ISS). Results: Out of the 117 patients studied, deletion 17p13 (p53) was present in 16 patients (13.67%). Thirty patients (25.64%) showed deletion 13q14.3. Three patients (2.56%) were detected to have t(4:14).Two patients (1.7%) had t(11:14) and t(14:16), respectively. Total of 19 patients (16.23%) in our study exhibited high risk cytogenetics and two among them had more than one high risk cytogenetic abnormalities. There was a 66.4% moderate correlation between ISS-III and high-risk cytogenetics which was statistically insignificant. Of the total 117 patients, 37 (31.62%) were staged R-ISS III. Conclusion: High risk cytogenetics was found in 16.23 % of our study population and del 17p13 was the most common high-risk cytogenetic abnormality. Of the studied subjects, 31.62% had R-ISS III, which is significantly higher compared to western population.

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“…Estimated OS in our study (Fig 2 A) was higher than those reported in other studies (western and Indian) as illustrated in Table 2 . 14 , 16 , 18 , 21 , 23 , 24 The higher OS in our study can be attributed to a better hospital network, pan-India referral system, and fully sponsored therapy with no cost to the patient and better living standards of our clientele.…”

Section: Discussionmentioning

confidence: 64%

Survival Outcomes of Newly Diagnosed Multiple Myeloma at a Tertiary Care Center in North India (IMAGe: 001A Study)

Yanamandra

Sharma

Shankar

et al. 2021

JCO Global Oncology

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PURPOSE The outcomes of patients with myeloma from developing countries are often lacking because of poor record maintenance. Publications from such settings are also limited because of the retrospective nature of the data collection. Information technology can bridge these gaps in developing countries with real-time data maintenance. We present the real-time survival data of the patients with myeloma from a tertiary care center in North India using one such indigenously built software. PATIENTS AND METHODS These are real-time data of all patients with myeloma presenting to a tertiary care center from North India. The patient characteristics (demographics, baseline disease characteristics, risk stratification, and outcomes) were recorded contemporaneously. The survival of the study population was analyzed and grouped based on various disease characteristics at diagnosis. RESULTS The median age of the study population (N = 696) was 65.9 (34.9-94.9) years with male predominance (65%). The median follow-up was 3.7 years (0-18.6 years) with the median overall survival (OS) not achieved. The OS of the study population at 1, 3, and 5 years was 94% (n = 558), 87.5% (n = 394), and 83.1% (n = 267), respectively. Most of the patients presented in advanced stages based on International Staging System (III:70%). On Kaplan-Meier analysis, the presence of weight loss ( P = .01), renal dysfunction ( P = .047), and anemia at diagnosis ( P = .004) had a significant impact on survival. On Cox proportional model univariate analysis, the presence of renal dysfunction, anemia, and weight loss had the significant hazard ratio of 1.68 (1-2.82, P = .049), 3.18 (1.39-7.29, P = .0063), and 2.81 (1.22-6.42, P = .014), respectively, whereas on multivariate analysis of hypercalcemia, renal disease, anemia, and bone disease (CRAB) features, only anemia was found to have a significant hazard ratio of 2.56 (1.01-6.47, P = .046). CONCLUSION The real-world data show OS comparable with the published western literature. Only anemia was found to have significant impact on survival. The use of such software can aid in better data-keeping in resource-constrained settings.

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Multiple myeloma: Experience of an institute in limited resource setting

Abstract: Proteasome inhibitors significantly improved the median survival for patients with MM (ISS II and ISS III) treated in a limited resource setting.

Cited by 14 publications

References 8 publications

Survival rate of multiple myeloma patients in Indonesia: A retrospective study in multiple myeloma at a single institution

Survival rate of multiple myeloma patients in Indonesia: A retrospective study in multiple myeloma at a single institution

Cytogenetics and Revised International Staging System (R-ISS): Risk Stratification in Multiple myeloma - A Retrospective Study in Indian Population

Survival Outcomes of Newly Diagnosed Multiple Myeloma at a Tertiary Care Center in North India (IMAGe: 001A Study)

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