How to treat multiple myeloma - a representative multicentre treatment survey.

Background: The present survey was undertaken to gain insights in the changes of disease management of multiple myeloma (MM) over time and the implementation of new guidelines into daily practice.

Patients And Methods: Diagnosis and treatment of MM were evaluated based on a 3-month representative multicentre survey including 386 patients from 35 centres in Germany in 2008. The results were compared to similar surveys in 2004 and 2006.

Results: At the time of first diagnosis, most patients (62.5%) were already in stage III (Durie-Salmon). The presence of deletion 13q was determined in 22% of patients only. However, determination of other prognostic factors has become increasingly well established. These include the levels of β2-microglobulin and serum albumin, each of which was determined in more than 2/3 of patients. Overall, 35% of patients were considered for high-dose chemotherapy. As a consequence of the development of innovative substances, there are remarkable shifts in first line, second line, and third line therapy with an increase in the use of bortezomib at all levels of therapy.

Conclusions: Regarding diagnostic measures, deviations from recommended guidelines became evident. Also, high-dose chemotherapy with stem cell support was considered in a minority of patients only. Novel substances, however, were rapidly integrated into the treatment of MM.