Abstracts
PO14
Treatment Outcomes in Newly Diagnosed Multiple Myeloma: Real-World Evidence from a Latin American Referral Center
Brenda Lizeth Acosta Maldonado, . – physician assistant, Hematology, Instituto Nacional de Cancerología; Amairani Carpintero Díaz, . – Hematology resident, Instituto Nacional de Cancerología; Omar Eduardo Fernández Vargas, . – Hematologist, Instituto Nacional de Cancerología; Amaya Llorente Chávez, . – physician assistant, Hematology, Instituto Nacional de Cancerología; Irma Karen Pellón Téllez, . – physician assistant, Hematology, Instituto Nacional de Cancerología; Luis Felipe Rubalcava Lara, . – physician assistant, Hematology, Instituto Nacional de Cancerología; Karla Alexandra Sánchez Hernández, . – physician assistant, Hematology, Instituto Nacional de Cancerología
Introduction/Background/Significance:
Outcomes in newly diagnosed multiple myeloma (NDMM) have improved significantly, yet real-world data from Latin America remains limited. We aimed to describe baseline characteristics, first-line treatment patterns, response, and early attrition in a real-world NDMM cohort.
Materials and Methods/Case Presentation/Objective:
We conducted a single-center, retrospective cohort study including consecutive adults with confirmed NDMM diagnosed between November 2024 and January 2026. Patients with non-myeloma monoclonal gammopathies or prior first-line therapy at another center were excluded. Data was extracted from medical records. Responses were classified according to the best documented response after induction. Descriptive statistics were used.
Results/Description/Main Outcome Measure(s):
Fifty-six patients were included. Median age was 58.5 years (IQR, 48.8-64.0), 36 patients (64.3%) were male. Median time between start of symptoms and diagnosis was 8.54 months. Bone disease was present in 55 patients (98.2%), extramedullary disease in 17 (30.4%), renal failure in 20 (35.7%), anemia in 31 (55.4%), and hypercalcemia in 17 (30.4%). ISS stage III was present in 17 patients (30.4%), cytogenetic risk was high in 12 patients (21.4%) and bone marrow infiltration >60% was documented in 13 patients (23.2%). Three patients (5.4%) experienced early death before induction, all due to pulmonary infection. Overall, 28 patients (50%) received a daratumumab-containing induction. Among 48 patients with documented response assessment, the overall response rate was 93.8% (45/48), including VGPR or better in 77.1% (37/48). Twenty-eight patients (50.0%) were referred for ASCT; however, only 8 (28.5% of the referred cohort) underwent transplantation during available follow-up, after a median time of 7 months after initiation of therapy. Seven patients (12.5%) had progressive disease, only 6 received second line treatment. At last follow-up, 10 patients (17.9%) had died, and 1 (1.8%) was lost to follow-up.
Conclusion(s).:
In this real-world Latin American NDMM cohort, patients were diagnosed at a substantially younger age and presented with a high burden of aggressive disease features compared with contemporary international cohorts. Although median age at diagnosis was 58.5 years, only half of the patients were considered for ASCT, probably reflecting a poor health condition at diagnosis. Anti-CD38-based induction therapy was not universal and there was a significant limitation in access to ASCT despite referral. Response rates among evaluable treated patients were high but clinically meaningful attrition occurred early and across the first line treatment pathway. These findings suggest that response rates alone may overestimate real-world treatment effectiveness and underscore the need to improve universal access to novel therapies and ASCT, as well as to identify systemic barriers that prevent patients in Latin America from early diagnosis and completing optimal frontline treatment strategies.
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