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A Multicenter Study of Clinical Presentations and Outcomes of Multiple Myeloma in Pakistan: The Real-World Analysis in a Resource-Constrained Country

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Abstract

This is the first multicenter study from Pakistan exploring the prevalence, clinical presentations and treatment outcomes of Multiple Myeloma patients. This retrospective study involved data collection from hospital record system of four tertiary care referral hospitals of Pakistan including all patients diagnosed as having Multiple Myeloma from January 2014 to December 2018. The demographic details, clinical presentations, laboratory findings, treatment responses, and mortalities were evaluated. The progression-free survival and overall survival were analyzed considering relapse and mortality as the end points, respectively. For the progression-free survival, the Kaplan–Meier survival analysis and the log rank test were used to compare the survival function for chemotherapy followed by autologous stem cell transplant (ASCT) as opposed to chemotherapy alone (non-ASCT). The overall survival analysis was assessed by Kaplan–Meier survival analysis. This study identified 403 Multiple Myeloma patients in five years. The median age at presentation was 55 years. Bortezomib based drug regimens were the most commonly used initial treatments (57.5%). Forty three patients received ASCT. The progression-free survival median for ASCT and non-ASCT patients were 50 months (95% CI, 42–57.9 months) and 26 months (95% CI, 21.5–30.5 months), respectively. The cumulative probability of survival rate at 60 months was 80%. This study identified 403 Multiple Myeloma patients over 5 years in four tertiary care hospitals of Pakistan. It underscores the importance of autologous stem cell transplant in Myeloma patients and advocates improving its facilities in Pakistan.

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Authors and Affiliations

  1. Shifa College of Medicine, Shifa Tameer E Millat University, Islamabad, Pakistan

    Nadia Saeed

  2. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan

    Usman Ahmad, Neelam Siddiqui & Faiza Iftikhar

  3. Agha Khan University Hospital, Karachi, Pakistan

    Munira Moosajee

  4. Hameed Latif Hospital, Lahore, Pakistan

    Zeeshan Ahmed Khan Niazi & Zeba Aziz

  5. National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

    Danish Hassan Khan

  6. Shifa International Hospital, Shifa Tameer E Millat University, Islamabad, Pakistan

    Imran Nazir Ahmad & Muhammad Ayaz Mir

Authors
  1. Nadia Saeed
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  2. Usman Ahmad
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  3. Munira Moosajee
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  4. Zeeshan Ahmed Khan Niazi
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  5. Neelam Siddiqui
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  7. Danish Hassan Khan
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Contributions

Substantial contributions to conception and development of methodology and acquisition of data: All authors. Analysis and interpretation of data NS, DHK, MAM. Drafting the article: NS, MM, MAM. Revising it critically for important intellectual content: All authors. Final approval of the version to be published: All authors. Agreement to be accountable for all aspects of the work: All authors. Supervision: MAM.

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Correspondence to Nadia Saeed.

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Saeed, N., Ahmad, U., Moosajee, M. et al. A Multicenter Study of Clinical Presentations and Outcomes of Multiple Myeloma in Pakistan: The Real-World Analysis in a Resource-Constrained Country. Indian J Hematol Blood Transfus 38, 309–318 (2022). https://doi.org/10.1007/s12288-021-01485-y

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  • DOI: https://doi.org/10.1007/s12288-021-01485-y

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