Real-World Data on First Relapse in Multiple Myeloma: Treatment Patterns and Outcomes in Finland Using Automated Data Collection

Objectives: This study aimed to characterize multiple myeloma (MM) patients at the first relapse and examine treatment outcomes. Methods: This registry-based retrospective study examined relapsed multiple myeloma patients in two Finnish Wellbeing Services Counties (Helsinki and Uusimaa, and Southwest Finland) from 2013 to 2022. Relapse was identified per current guidelines using serum paraprotein, plasma immunoglobulins, and free light chain data. Data were collected from hospital data lakes, Social Insurance Institution and Digital and Population Services Agency. Patients were stratified by age (≤70 vs >70), index year, and time to first relapse (≤2 vs >2 years post-diagnosis). Results: Of 1,221 patients treated for MM between 2012–2022, 286 met the study inclusion criteria. Median overall survival from the relapse was higher in the younger patients (32.4 months vs 20.0 months). In the first half of follow-up, lenalidomide was the most common pharmacotherapy in both age groups. After 2018, CD38-based treatments and pomalidomide increased significantly for younger patients, remaining limited in the elderly. Conclusions: While new therapies have been adopted for younger MM patients, the treatment of older patients at first relapse has had little change. Given their poorer outcomes, there is a need to improve care for older MM patients.