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We investigated patient characteristics, treatment durations and outcomes, and symptom burden across the treatment pathway in Belgium, France, Germany, Italy, Spain, Switzerland and the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>. In total, 435 physicians retrospectively reviewed 4997 patient charts. Profiles of patients diagnosed with multiple myeloma during the last 12\u00a0months were similar across countries; bone pain was the most common presentation. Median duration of first\u2010line therapy was 6\u00a0months, followed by a median treatment\u2010free interval of 10\u00a0months; both these decreased with increasing lines of therapy, as did time to progression. Depth of response, as assessed by the treating physician, also decreased with each additional line of therapy: 74% of patients achieved at least a very good partial response at first line, compared with only 11% at fifth line. Deeper responses were associated with longer time to progression, although these were physician\u2010judged. Toxicities and co\u2010morbidities increased with later treatment lines, and were more likely to have led to discontinuation of treatment. These real\u2010world data provide an insight into patient outcomes and treatment decisions being made in clinical practice.<\/jats:p>","DOI":"10.1111\/bjh.14213","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T15:52:53Z","timestamp":1468511573000},"page":"252-264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":302,"title":["Multiple myeloma: patient outcomes in real\u2010world practice"],"prefix":"10.1111","volume":"175","author":[{"given":"Kwee","family":"Yong","sequence":"first","affiliation":[{"name":"Department of Haematology University College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Delforge","sequence":"additional","affiliation":[{"name":"Department of Haematology UZ Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology Kantonsspital St Gallen St Gallen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Fink","sequence":"additional","affiliation":[{"name":"Kantar Health Montrouge France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Flinois","sequence":"additional","affiliation":[{"name":"Kantar Health Montrouge France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Gonzalez\u2010McQuire","sequence":"additional","affiliation":[{"name":"Global Health Economics Amgen (Europe) GmbH Zug Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Safaei","sequence":"additional","affiliation":[{"name":"Global Health Economics Amgen (Europe) GmbH Zug Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Karlin","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Lyon\u2010Sud Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria\u2010Victoria","family":"Mateos","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital of Salamanca Salamanca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-6922","authenticated-orcid":false,"given":"Marc S.","family":"Raab","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Schoen","sequence":"additional","affiliation":[{"name":"Value Access &amp; Policy Amgen (Europe) GmbH Zug Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cavo","sequence":"additional","affiliation":[{"name":"'Ser\u00e0gnoli' Institute of Hematology and Medical Oncology Bologna University School of Medicine Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-012-1548-y"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402551"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2006.00739.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000515)19:9<1141::AID-SIM479>3.0.CO;2-F"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070594"},{"key":"e_1_2_8_7_1","volume-title":"Multiple Myeloma, Cancer of the Bone Marrow: Concise Review of the Disease and Treatment Options","author":"Durie B.G.M.","year":"2011"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197509)36:3<842::AID-CNCR2820360303>3.0.CO;2-U"},{"key":"e_1_2_8_9_1","first-page":"684","article-title":"Multiple myeloma: from diagnosis to treatment","volume":"42","author":"Eslick R.","year":"2013","journal-title":"Australian Family Physician"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.242"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4065\/79.7.867"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4065\/78.1.21"},{"key":"e_1_2_8_13_1","unstructured":"van der Laan M.J.&Dudoit S.(2003)Unified cross\u2010validation methodology for selection among estimators and a general cross\u2010validated adaptive epsilon\u2010net estimator: finite sample oracle inequalities and examples. 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