Myeloma at Cross Roads in India

Yanamandra, Uday; Malhotra, Pankaj

doi:10.1007/s12288-018-1026-x

Cited by 5 publications

(6 citation statements)

References 13 publications

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“… 11 The epidemiology and outcomes of the disease in India are often considered different from the west owing to an earlier age of onset and limited resources. 2 , 6 However, most of these studies are limited by selection bias and their deductions based on secondary objectives. Our study included all sequential patients managed at a tertiary care center in Northern India to avoid these biases in prospectively reporting the epidemiology of MM from this part of the world.…”

Section: Discussionmentioning

confidence: 99%

“…Managing a patient with MM in India has several constraints, including the availability of infrastructure (equipment, expertise, and quality assurance), reluctance to avail autologous stem-cell transplant (ASCT), frequent change of health care facilities, and lack of data sharing between institutions and health insurance. 1 , 2 Survival depends on multiple factors including type and duration of therapy, initial response, compliance to therapy, availability of drugs, and feasibility of providing ASCT. 3 In India, the outcome in MM has improved substantially over recent years, as a result of the availability of multiple novel agents with an acceptable safety profile.…”

Section: Introductionmentioning

confidence: 99%

“… 3 In India, the outcome in MM has improved substantially over recent years, as a result of the availability of multiple novel agents with an acceptable safety profile. 2 Also, the increasing number of autologous transplants in the country has improved the overall survival (OS) of these patients. 4 The overall impact on survival by improved strategies in the country has rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Multiple myeloma is the second commonest hematological malignancy with rising incidence across the globe [1]. Myeloma afflicts individuals a decade younger in our country with a median age in the 4-5th decade as compared to subjects with Indian descents living in the US [2][3][4]. The younger population in our country also present with higher ISS stage and extramedullary disease.…”

mentioning

confidence: 83%

“…This has led to an improvement in median survival of myeloma patients from 3 to 4 years to more than 10 years in standard risk patients. The novel and novel-novel antimyeloma drugs are so effective that they are challenging the role of autologous stem cell transplantation in the treatment of multiple myeloma [3]. However, the fact is that myeloma remains an incurable illness for the majority of patients.…”

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confidence: 99%

Stem Cell Transplantation in Multiple Myeloma: Very Much Alive and Kicking

Yanamandra

Malhotra

2019

Indian J Hematol Blood Transfus

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Expression levels and patterns of B‐cell maturation antigen in newly diagnosed and relapsed multiple myeloma patients from Indian subcontinent

Sriram

Kunjachan

Khanka

et al. 2022

Cytometry Part B Clinical

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Background Many novel therapies are being evaluated for the treatment of Multiple myeloma (MM). The cell‐surface protein B‐cell maturation antigen (BCMA, CD269) has recently emerged as a promising target for CAR‐T cell and monoclonal‐antibody therapies in MM. However, the knowledge of the BCMA expression‐pattern in myeloma patients from the Indian subcontinent is still not available. We present an in‐depth study of BCMA expression‐pattern on abnormal plasma cells (aPC) in Indian MM patients. Methods We studied BM samples from 217 MM patients (211‐new and 6‐relapsed) with a median age of 56 years (range, 30–78 years & M:F‐2.29) and 20 control samples. Expression levels/patterns of CD269 (clone‐19f2) were evaluated in aPCs from MM patients and in normal PCs (nPC) from uninvolved staging bone marrow samples (controls) using multicolor flow cytometry (MFC). Expression‐level of CD269 was determined as a ratio of mean fluorescent intensity (MFI‐R) of CD269 in PCs to that of non‐B‐lymphocytes and expression‐pattern (homogenous/heterogeneous) as coefficient‐of‐variation of immunofluorescence (CVIF). Results Median (range) percentage of CD269‐positive abnormal‐PCs in total PCs was 71.6% (0.49–99.29%). The MFI‐R (median, range) of CD269 was significantly higher in aPCs (4.13, 1.12–26.88) than nPCs (3.33, 1.23–12.87), p < .0001. Median (range) MFI of CD269 at diagnosis and relapse were 2.39 (0.77–9.57) and 2.66 (2.15–3.23) respectively. CD269 levels were similar at diagnosis and relapse, p = .5529. Conclusions We demonstrated that BCMA/CD269 is highly expressed in aPCs from a majority of MM patients, both at diagnosis and relapse. Thus, BCMA is a valuable target for therapy for Indian MM patients.

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Myeloma at Cross Roads in India

Cited by 5 publications

References 13 publications

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

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

Stem Cell Transplantation in Multiple Myeloma: Very Much Alive and Kicking

Expression levels and patterns of B‐cell maturation antigen in newly diagnosed and relapsed multiple myeloma patients from Indian subcontinent

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