Publication Only: Myeloma and other monoclonal gammopathies - Clinical
The incidence of MM varies greatly between countries, but since 1990 it has increased steadily. Despite improvements in the care of patients with MM, these advances have largely delivered better outcomes to patients in high-income countries. Moscow is a big city (12.6 million inhabitants in 2018) with relatively identical protocols for the diagnosis, staging and treatment of MM.
To evaluate the incidence and mortality of MM depending on age, gender and year of observation in Moscow in 2009-2019.
Data of 3,942 MM patients (pts) who reside in Moscow and were treated at Moscow City Hematology Center (Botkin Hospital) have been studied. It was collected from out- and in-patient clinical records and state registries. The period from 2009 through 2019 was analyzed. The median follow up of patients since the diagnosis of MM was 34 (1 - 423) months.
Among the registered 3,942 patients with MM, 1,707 were men (43%) and 2,241 women (57%). The median age at diagnosis was 65 (23-93) years. For men, it was 63 (23-93), for women - 66 (29-92) years. Most of the patients were older than 65 - 2047 (51.9%). Over the 10-year period, the median age at diagnosis has increased by 3 years - from 64 to 67 years.
The average annual MM incidence recorded for 10 years increased by 60.52% - from 1.9 to 3.05 per 100,000 population. However, such increase in the incidence was observed only for a cohort of patients older than 50 years, achieving a peak in the age range of 60 - 69 years. Prevalence rate (PR) of MM has grown from 8.0 per 100,000 population in 2009 to 15.2 in 2018, mostly due to improved therapy outcomes. 2-year overall survival was 76%, 5-year - 49%, and 10-year -27%. Median overall survival of pts younger than 65 years of age at diagnosis was 79 months, 65 and older-48 months.
Significant changes in MM epidemiology in the City of Moscow were observed. In the last 10 years, the incidence has increased mostly due to the increase of life expectancy, whereas improved MM diagnostics and treatment resulted in substantial increase in OS. In turn, this have caused MM PR increase, and this trend will most likely continue in the future.