Impact of age, sex, ethnicity, socio-economic deprivation and novel pharmaceuticals on the overall survival of patients with multiple myeloma in New Zealand.

Abstract

The impact of age, ethnicity and socio-economic deprivation in the era of novel anti-myeloma agents is unclear. Using linked national data from New Zealand, we evaluated the incidence, prevalence and overall survival (OS) of individuals who were diagnosed with myeloma between 2004 and 2016. The crude incidence rate increased from 5·42 to 8·47/100 000 and the age-standardised rate increased from 4·01 to 5·28/100 000. The estimated prevalence in December 2016 was 37·8/100 000. Median OS increased from 34·8 (95% CI 31·4, 39·3) months in 2004-2007 to 50·7 (48·5, 57·3) months in 2012-2016. Following the public funding of bortezomib in 2011, the median OS for individuals >70 years increased from 19·4 (16·3, 23·1) to 28·6 (24·5, 32·8) months. For those ≤70 years of age who did not have autologous stem cell transplantation (ASCT), median OS increased from 49·1 (37·1, 57·5) to 62·7 (51·7, 79·2) months; but for those who had ASCT, there was no difference in median OS. Socio-economic deprivation was an independent adverse prognostic factor. Māori/Pasifika and those in the most deprived quintile experienced no improvement in survival after bortezomib was funded. Our study confirms the increasing incidence and improving survival of myeloma patients, and the negative impact of Māori/Pasifika ethnicity and socio-economic deprivation on survival.