Work

Multiple Myeloma in a Resource‐Limited Setting: Clinical Presentation, Treatment Patterns, and Outcomes From a 99‐Patient Cohort in Senegal

Year: 2026

Type: article

Abstract: ABSTRACT Background : Therapeutic advances have profoundly improved outcomes in multiple myeloma (MM) in high‐income countries. In sub‐Saharan Africa; however, data remain scarce and access to novel therapies is limited. We aimed to characterize the clinical presentation, treatment strategies, and outcomes of MM patients managed in a resource‐limited setting. Methods : We conduct a retrospective monocentric study including 99 patients diagnosed with MM according to International Myeloma Working Group (IMWG) criteria between 2011 and 2022 at the Hôpital Principal de Dakar. Clinical, biological, radiological, therapeutic, and outcome data were analyzed. Overall survival (OS) and progression‐free survival (PFS) were estimated using the Kaplan–Meier method, and prognostic factors were assessed using univariable and multivariable Cox proportional hazards regression. Results : The mean age at diagnosis was 62.4 years, with a slight male predominance. Diagnosis was symptomatic in 86.9% of patients, mainly due to bone pain (62.6%). Advanced disease was common, with 68.7% presenting at Salmon–Durie stage III. Renal impairment and hypercalcemia were observed in 57.0% and 50.5% of cases, respectively. First‐line treatment relied predominantly on conventional regimens (melphalan–prednison± thalidomide), while bortezomib‐based therapies were used in only 11.1% of patients. After a median follow‐up of 16 months, median OS was 73 months (95% CI: 23–NR) and median PFS was 31 months (95% CI: 23–NR); estimated OS was 60.0% at 12 months and 36.4% at 24 months. International Staging System (ISS) stage was the only independent predictor of OS (Stage III vs. Stage I: HR 13.4; 95% CI: 1.58–1755; p = 0.012). Nearly half of the cohort (49.5%) was lost to follow‐up. Conclusions : In this Senegalese cohort, MM was diagnosed at an advanced stage and treated mainly with conventional regimens, resulting in poor survival outcomes compared with high‐income settings. ISS stage was the strongest independent prognostic factor identified. These findings highlight persistent global disparities in MM care and underscore the urgent need for adapted diagnostic and therapeutic strategies, and for strategies to reduce loss to follow‐up, in low‐ and middle‐income countries. Trial Registration : The authors have confirmed clinical trial registration is not needed for this submission.

Source: eJHaem

DOI: 10.1002/jha2.70402