Assessment of treatment outcomes in multiple myeloma according to prognostic factors and therapeutic approach

Multiple myeloma is a malignant plasma cell disorder characterized by clonal proliferation of abnormal plasma cells. Global five-year survival rates range from 60% to 70%, largely due to novel therapeutic strategies. In our country, conventional therapies remain standard, with monoclonal antibodies recently introduced for relapsed/refractory cases. This study aimed to assess treatment outcomes in relation to therapy type and prognostic factors. A retrospective-prospective analysis was conducted on 200 patients with multiple myeloma. The relationship between treatment modality, disease biology, clinical status, and therapeutic response was evaluated, including progression-free survival (PFS), overall survival (OS), and protocol efficacy across prognostic subgroups. Best treatment responses were achieved in patients with good performance status and low comorbidity, particularly those receiving first-line VTD (bortezomib, thalidomide, dexamethasone). Among patients under 65, the CTD (cyclophosphamide, thalidomide, dexamethasone) protocol showed the longest average OS. In second-line therapy, PAD (bortezomib, doxorubicin, dexamethasone) yielded the highest response rates and best survival outcomes. Elderly patients with high Charlson Comorbidity Index (CCI) benefited most from the MPT regimen (melphalan, prednisone, thalidomide). In contrast, Vel-Dex (bortezomib, dexamethasone) was linked to the highest progression rates. Therapeutic outcome in myeloma strongly correlates with prognostic factors and treatment selection. Proper risk stratification enables personalized therapy and improves outcome.