Real-World Use of 3rd Line Therapy for Multiple Myeloma in Austria: An Austrian Myeloma Registry (AMR) Analysis of the Therapeutic Landscape and Clinical Outcomes prior to the Use of Next Generation Myeloma Therapeutics

PLoS One. 2016 Mar 3;11(3):e0147381. doi: 10.1371/journal.pone.0147381. eCollection 2016.


Objective: Clinical trials demonstrate improving survival in patients with multiple myeloma (MM) after treatment. However, it is unclear whether increased survival translates to a similar benefit in a real world setting.

Methods: We analyzed the overall survival of 347 multiple myeloma patients in Austria by means of a national registry (AMR), focused on results from 3rd and later lines of therapy. This benchmark was chosen to define a baseline prior to the broad application of upcoming 2nd generation drugs (carfilzomib, pomalidomide).

Results: Projected 10 years survival for patients with MM in Austria is estimated to be 56% in patients diagnosed in between the years 2011-2014, 21% in patients with a diagnosis made between 2000-2005, and 39% in those with a diagnosis made between 2006-2010). For the same intervals a significant increase in the use of both bortezomib, lenalidomide and thalidomide-so called IMiDs (from 2005 onwards) and their simultaneous use in combination therapies (from 2010 onwards) could be shown. The use of autologous transplantation (ASCT) remained more or less constant at ~ 35% of patients in the 1st line setting over the whole period, comparing well to international practice patterns, while the use of 2nd line ASCT increased from 5.5% to 18.7% of patients. Patients in 3rd or later line treatment (n = 105), showed that even in relapsed and refractory disease median survival was 27 months with a considerable proportion of long-term survivors (~20%).

Conclusion & perspective: With the expected emergence of additional active anti-myeloma compounds, we aim to assess survival in patients with relapsed and refractory MM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Austria
  • Bortezomib / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lenalidomide
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology
  • Multiple Myeloma / therapy*
  • Oligopeptides / therapeutic use
  • Prognosis
  • Recurrence
  • Registries*
  • Retrospective Studies
  • Survival Analysis
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Transplantation, Autologous


  • Oligopeptides
  • Thalidomide
  • Bortezomib
  • carfilzomib
  • pomalidomide
  • Lenalidomide

Grant support

The research leading to these results has received funding from the European Union Seventh Framework Program (FP7/2007-2013) OPTATIO (WW, RW) under grant agreement n°278570” [], as well as by the COMET Center ONCOTYROL (EW, RW, UR)—[]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.