[Survival of patients affected with multiple myeloma at the Department of Internal Medicine and Haematology of Semmelweis University].

Introduction: Survival in multiple myeloma has improved over the past two decades, mostly due to the emergence of new treatment options. Results from clinical trials, however, may differ from real-world experiences, underscoring the importance of collecting “real-world” data as well. Objective and method: We examined the clinical and survival data of all myeloma patients diagnosed at the Department of Internal Medicine and Haematology (formerly the 3rd Department of Internal Medicine) of Semmelweis University, between 2008 and 2021. We evaluated survival depending on the date of diagnosis and additional factors including the International Staging System, karyotype, presence of bone lesions, renal failure, and first-line therapy. Since 2013, myeloma patients have been looked after in a subspecialty clinic, which may also affect outcomes. Results: Overall, we diagnosed 284 patients in this period, with the annual number of diagnoses tripling in recent years. Treatment strategies underwent significant changes, with novel drugs replacing chemotherapy, increasingly administered in triple or quadruple combinations. The median overall survival (OS) for the entire group was 54 months, but it significantly varied based on the era of diagnosis: it was 35 months for patients diagnosed between 2008 and 2011, 44 months between 2012 and 2015, and 50 months between 2016 and 2019, respectively, with the most recent period post-2020 yet to reach the median. Conclusion: Our study confirms that the introduction of new drugs nearly doubled the expected median survival in real life as well. This improvement can be attributed, in part, to a significant reduction in early mortality (related to refractoriness and septic complications) in comparison to prior periods and also to the availability of more options at relapse. Additionally, we consider the accumulated experience, the unified approach to treatment and monitoring, and the availability of clinical trials in our dedicated myeloma clinic non-negligible factors in this improvement. Orv Hetil. 2024; 165(39): 1539–1547