Characteristics and survival trends in Finnish multiple myeloma patients—a nationwide real-world evidence study

Multiple myeloma (MM) is a hematologic cancer displaying an abnormal heterogenous B cell population in the bone marrow that overproduce monoclonal immunoglobulins, causing organ and tissue damage. MM is one of the most common types of blood cancers after lymphoma, accounting for 1% of all cancers and 10% of all hematologic cancers. The incidence of MM has increased globally since 2000 and approximately 5-7 cases per 100,000 people are diagnosed annually in Finland. MM is particularly prevalent in the elderly population, median age at diagnosis being 65–70 years.

Current understanding of the epidemiology and outcomes for patients with MM in Finland is scarce due to lack of comprehensive real-world evidence from clinical practice. In this nationwide retrospective study, multiple data sources were utilized to investigate the real-world epidemiological characteristics and treatment outcomes of patients diagnosed with and treated for MM between 2005 and 2016 in Finland. The aims of the study were to describe characteristics of MM patients at diagnosis (age, sex, comorbidity) and to estimate annual incidence as well as overall survival. Moreover, time trends in autologous stem cell transplantation (ASCT) frequency and survival were analyzed. The study was conducted in collaboration with Takeda.

The analysis included 3,851 adult patients diagnosed with MM meeting all inclusion criteria. The average myeloma incidence was 6/100,000 people, with an age-standardized incidence of 3/100,000 people, showing a small increase during the follow-up. The proportion of patients receiving ASCT increased during the years 2005–2015 from 17% to 30%. Most patients under 65 years of age received ASCT treatment (60.5%), whereas only 8.7% of patients 65 years of age or older received ASCT. The net median overall survival improved from 2005–2010 (3.44 years) to 2011–2016 (3.89 years), presenting an annual 4% reduction in the risk of death after adjusting for covariates. This development was associated with an increased utilization of ASCT treatment regimens as well as a shift in the treatment population towards older and more frail subjects. Achieving similar or even improved crude survival with frailer patients indicates relative improvements in the treatment of MM patients.