Relapsed/Progressive Disease and Its Prognostic Factors among Multiple Myeloma Patients Receiving Novel Agent Treatment in North East Peninsular Malaysia: A Single Centre Experience.

BACKGROUND: Some multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors. METHODS: This study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors. RESULTS: Sixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36-37.29). The type of paraprotein at diagnosis (P = 0.026, P = 0.228), International Staging System (ISS) score (P = 0.036, P = 0.067) and autologous stem cell transplant (ASCT) (P = 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression (P = 0.003). CONCLUSION: Our study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.