Myelombehandling på SÄS - Håller den god nationell standard?

Abstract

Abstract Myeloma Treatment on SÄS – Does it conform to good national standard? Stefan Carslöv Supervisor: Ulf-Henrik Mellqvist Department of Medicine, Södra Älvsborg Hospital, Borås, Sweden Introduction Myeloma has an incidence of approximately 600 patient per year in Sweden. There are several different treatment to choose from, and the cost for the clinic can drastically rise when using the newest treatments. Aim The aim was to study the treatment of myeloma on SÄS, Borås compared to the national results. The results was measured as total survival. Also, differences in treatment regimes were studied. Methods The study was retrospective and the data was collected from the national quality register for myeloma. For survival all patients diagnosed between 2008-01-01 to 2013-12-31 was extracted from the database and after that the patient at SÄS, Borås was separated. The treatments given was also extracted from the database. Results The total survival at SÄS, Borås was lower than the national survival. The results was not statistically significant, but when an age standardization was done the significance rose and a difference of almost 2 years lower survival at SÄS was seen. The most used treatment at SÄS was autologous stem cell transplantation for patients <65 years old, and melphalan+steroids+thalidomide for patients >65 years old. Conclusion The difference in survival might depend on that the Västra Götalandsregionen is very restrictive using autologous stem cell transplantation as treatment modality in elderly patients. Another possibility is differences in reporting patients not receiving active treatment due to comorbidities. The findings in this study needs further evaluation and follow up but it has already lead to a more liberal approach to use autologous transplantation as treatment also for the elderly.