PMID- 36765918 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230213 IS - 2072-6694 (Print) IS - 2072-6694 (Electronic) IS - 2072-6694 (Linking) VI - 15 IP - 3 DP - 2023 Feb 2 TI - Attrition Rates in Multiple Myeloma Treatment under Real World Conditions-An Analysis from the Austrian Myeloma Registry (AMR). LID - 10.3390/cancers15030962 [doi] LID - 962 AB - Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for >/=5 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous stem cell transplantation (SCT, transplant eligible = TE)) with primarily VRd (Bortezomib/Lenalidomide/Dexamethasone) given as induction (26.5%), followed by lenalidomide maintenance in 55.7% of cases. Transplant-ineligible (NTE) patients were predominantly treated with Vd (Bortezomib/Dexamethasone, 21.6%), receiving maintenance in 27.1%. A total of 37.5% received a second LoT. ARs across one to five LoTs were 16.7-27%. Frontline induction/ SCT followed by maintenance reduced ARs associated with age and achievement of deep remission in the frontline. Deep remission prolongs follow-up and time-to-next-treatment (TTNT), while high-risk-cyctogenetics negatively affected these outcomes. Our results demonstrate considerably lower ARs for MM patients within the AMR data versus other healthcare systems. Young age and the achievement of significant remissions after optimal frontline therapy resulted in particularly low ARs. These promising results support a key role for the ease of drug access and reimbursement policies in governing long-term MM patient outcomes. FAU - Benda, Magdalena A AU - Benda MA AD - Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria. AD - Private University of the Principality of Liechtenstein, 9495 Triesen, Principality of Liechtenstein. FAU - Ulmer, Hanno AU - Ulmer H AUID- ORCID: 0000-0001-5911-1002 AD - Institute of Medical Statistics and Informatics, Medical University of Innsbruck, 6020 Innsbruck, Austria. FAU - Weger, Roman AU - Weger R AD - Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria. AD - syndena GmbH, Connect to Cure, 6020 Innsbruck, Austria. FAU - Reimann, Patrick AU - Reimann P AD - Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria. AD - Private University of the Principality of Liechtenstein, 9495 Triesen, Principality of Liechtenstein. FAU - Lang, Theresia AU - Lang T AD - Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria. FAU - Pichler, Petra AU - Pichler P AD - Internal Medicine I: Hematology, Oncology, Nephrology & Endocrinology St. Polten, Medical University of St. Polten, 3100 St. Polten, Austria. FAU - Winder, Thomas AU - Winder T AD - Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria. FAU - Hartmann, Bernd AU - Hartmann B AUID- ORCID: 0000-0001-8831-3746 AD - Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria. FAU - Strassl, Irene AU - Strassl I AUID- ORCID: 0000-0001-9649-5850 AD - Division of Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Department of Internal Medicine I, Ordensklinikum Linz, Fadingerstrasse 1 and Seilerstatte 4, 4020 Linz, Austria. AD - Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria. FAU - Krauth, Maria Theresa AU - Krauth MT AD - Department of Internal Medicine I, Division Hematology & Hemostaseology, Medical University Vienna, 1090 Wien, Austria. FAU - Agis, Hermine AU - Agis H AD - Department of Internal Medicine I, Division Hematology & Hemostaseology, Medical University Vienna, 1090 Wien, Austria. FAU - Sormann, Siegfried AU - Sormann S AD - Internal Medicine, Division of Hematology, Medical University of Graz, 8036 Graz, Austria. FAU - Podar, Klaus AU - Podar K AD - Department of Internal Medicine II, University Hospital Krems, and Molecular Oncology and Hematology Unit, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria. FAU - Willenbacher, Wolfgang AU - Willenbacher W AD - Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria. AD - syndena GmbH, Connect to Cure, 6020 Innsbruck, Austria. FAU - Willenbacher, Ella AU - Willenbacher E AUID- ORCID: 0000-0003-2853-5405 AD - Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria. LA - eng PT - Journal Article DEP - 20230202 PL - Switzerland TA - Cancers (Basel) JT - Cancers JID - 101526829 PMC - PMC9913775 OTO - NOTNLM OT - attrition rate OT - multiple myeloma OT - treatment patterns COIS- The authors declare that they have no conflicts of interest. EDAT- 2023/02/12 06:00 MHDA- 2023/02/12 06:01 PMCR- 2023/02/02 CRDT- 2023/02/11 01:04 PHST- 2022/12/26 00:00 [received] PHST- 2023/01/25 00:00 [revised] PHST- 2023/01/28 00:00 [accepted] PHST- 2023/02/11 01:04 [entrez] PHST- 2023/02/12 06:00 [pubmed] PHST- 2023/02/12 06:01 [medline] PHST- 2023/02/02 00:00 [pmc-release] AID - cancers15030962 [pii] AID - cancers-15-00962 [pii] AID - 10.3390/cancers15030962 [doi] PST - epublish SO - Cancers (Basel). 2023 Feb 2;15(3):962. doi: 10.3390/cancers15030962.