Kerbauy LN, Parmar S, Kutner JM, de Gusmão BM, Hamerschlak N. Hematological approaches to multiple myeloma: trends from a Brazilian subset of hematologists. A cross-sectional study.
SAO PAULO MED J 2016;
134:335-41. [PMID:
27557143 PMCID:
PMC10876334 DOI:
10.1590/1516-3180.2015.0223030416]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/03/2016] [Indexed: 01/17/2023] Open
Abstract
CONTEXT AND OBJECTIVE
For the last nine years, hematologists and oncologists have gathered annually at an educational symposium organized by a Brazilian and an American hospital. During the 2015 Board Review, a survey among the attendees evaluated the differences in management and treatment methods for multiple myeloma (MM).
DESIGN AND SETTING
Cross-sectional study during an educational hematology symposium in São Paulo, Brazil.
METHODS
Hematologists present at the symposium gave responses to an electronic survey by means of mobile phone.
RESULTS
Among the 350 attendees, 217 answered the questionnaire. Most of the participants believed that immunotargeting agents (iTA) might be effective for slowing MM progression in heavily pretreated patients (67%) and that continued exposure to therapy might lead to emergence of resistant clones in patients with MM (76%). Most of the physicians use maintenance therapy after hematopoietic stem cell transplantation (95%) and 45% of them would further restrict it to post-transplantation patients with underlying high-risk disease. The first-line drugs used for transplantation-ineligible patients (TI-MM) were bortezomib-thalidomide-dexamethasone (31%), bortezomib-dexamethasone (28%), lenalidomide-dexamethasone (Rd; 17%) and melphalan-based therapy (10%). Lenalidomide was the drug of choice for post-transplantation maintenance for half of the participants. No significant differences were observed regarding age or length of experience.
CONCLUSION
The treatment choices for TI-MM patients were highly heterogenous and the melphalan-based regimen represented only 10% of the first-line options. Use of maintenance therapy after transplantation was a common choice. Some results from the survey were divergent from the evidence in the literature.
Collapse