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. 2025 May 5:64:598-606.
doi: 10.2340/1651-226X.2025.42647.

Evolution of treatment practices and outcomes in multiple myeloma during 2013-2022: a Finnish real world registry study

Anu Partanen  1 , Marika Waltari  2 , Johanna Vikkula  3 , Riikka Mattila  3 , Katja Närhi  2 , Jonna Eeva  4 , Mervi Putkonen  5
Affiliations

Evolution of treatment practices and outcomes in multiple myeloma during 2013-2022: a Finnish real world registry study

Anu Partanen et al. Acta Oncol. .

Abstract

Background and purpose: Multiple myeloma (MM) is a heterogenous hematologic malignancy with an evolving treatment landscape. This Finnish real-world evidence study clarifies the evolution of treatment practices and outcomes over recent years.

Methods: This retrospective analysis included 1,733 patients with MM diagnosed between 2013 and 2022. The cohort was identified and electronic health record data were collected from four hospital data lakes and linked to national registries, covering 54% of Finland's population. Patients were divided by stem cell transplantation (SCT) status into a SCT group (512 patients) and a non-SCT group (1,221 patients), and further by diagnosis period (2013-2017 vs. 2018-2022).

Results: The average age of the patients was 71.3 years at diagnosis. Novel therapeutic use markedly increased during the follow-up, especially lenalidomide as part of frontline and maintenance therapy in SCT patients. For SCT patients the 4-year survival rate improved from 81.7% (95% confidence interval [CI]: 76.4-86.0) in 2013-2017 to 93.0% (95% CI: 87.0-96.3) in 2018-2022. For non-SCT-patients, the median overall survival (OS) increased slightly from 41.3 months (95% CI: 38.1-45.6) in the 2013-2017 period to 43.8 months (95% CI: 39.8-55.3) in the 2018-2022 period, although the difference was not statistically significant. High risk cytogenetics and high International Staging System class appeared to persist as factors indicating shorter OS.

Interpretation: While advancements of novel drugs have resulted in a notable survival benefit for patients undergoing SCT, the survival of non-SCT-patients has remained comparatively static. New approaches in the treatment of MM for elderly and frail non-SCT patients are warranted.

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Conflict of interest statement

MW and KN are employees of Johnson & Johnson. AP declares honoraria for lectures from Behring and Abbvie and has participated in the Scientific Advisory Boards Abbvie, Janssen-Cilag, Novartis, Pfizer, Sanofi and Takeda. MP declares honoraria for lectures from and membership on advisory boards with BMS, Janssen, Pfzer and Sanofi, and consultancy for Janssen and Pfzer. JE, JV and RM have no interests to declare.

Figures

Figure 1
Figure 1
Trends in the use of MM drugs for SCT patients (upper panels) and non-SCT patients (lower panel). For SCT patients, the left panel represents induction treatment(s) and the right panel represents the first treatment line after SCT treatment. Note that consolidation and maintenance therapies are not depicted here but are presented in Supplementary Figure 1. For non-SCT patients, the left panel shows 1L (first-line) treatment and the right panel shows 2L (second-line) treatment. MM: Multiple myeloma; SCT: stem cell transplantation.
Figure 2
Figure 2
Sankey plots of four first treatment lines for non-SCT patients (A), SCT-patients before the first SCT (B), and SCT-patients after the first SCT (C). SCT: stem cell transplantation.
Figure 3
Figure 3
OS of non-SCT (A) and SCT (B) patients during 2013–2017 (black lines) and 2018–2022 (blue lines). Shaded areas represent 95% CI. OS: overall survival; SCT: stem cell transplantation; CI: confidence interval.
Figure 4
Figure 4
Cox proportional hazards model of OS for SCT-receiving patients. OS: overall survival; SCT: stem cell transplantation.
Figure 5
Figure 5
OS of MM patients compared to age, sex and home municipality matched controls for (a) overall MM cohort (b) SCT-patients (c) non-SCT patients. Shaded areas represent 95% CI. OS: overall survival; MM: MM: Multiple myeloma; SCT: stem cell transplantation; CI: confidence interval.
See this image and copyright information in PMC

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