{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T15:04:55Z","timestamp":1775228695625,"version":"3.50.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bristol Myers Squibb K.K."}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Despite recent advances in the range of therapies available for the treatment of multiple myeloma (MM), there are limited data surrounding survival outcomes and baseline characteristics influencing survival in general clinical practice in Japan. The aim of this study was to use electronic medical records (EMRs) to examine overall survival (OS) and prognostic factors in Japanese patients with MM. We extracted EMRs in the Real World Data (RWD) database of patients with a confirmed diagnosis of MM and treatment history with bortezomib, thalidomide, and\/or lenalidomide. OS and prognostic factors for OS were analyzed using a univariate analysis and decision tree model. Of the 6509 patients in the database with a diagnosis of MM, 1565 were eligible. Patients had a median (range) age of 72 (23\u201392) years, a median OS of 53.5 months, and a 5-year OS rate of 45.6%. In alignment with previous studies, International Staging System stage and age were prognostic of OS. In addition, platelet and erythrocyte counts, chloride, total protein, C-reactive protein, and lactate dehydrogenase levels were identified as important prognostic factors for OS and were used to pilot a simple prognostic tool. In conclusion, we found that the survival outcomes extracted from EMRs in the RWD of Japanese patients with MM aligned with a previous retrospective study from Japan. Baseline laboratory parameters prognostic for OS were explored with additional factors to International Staging System and age identified. These might be used to optimize treatment selection, although further investigation using additional data sources is required.<\/jats:p>","DOI":"10.1371\/journal.pone.0285947","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T17:54:12Z","timestamp":1685555652000},"page":"e0285947","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Survival outcomes among patients with multiple myeloma in the era of novel agents: exploratory assessment using an electronic medical record database in Japan"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8577-5184","authenticated-orcid":true,"given":"Shuji","family":"Uno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuichi","family":"Midorikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Ichikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junya","family":"Kuroda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenshi","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"pone.0285947.ref001","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s12185-019-02636-8","article-title":"JSH practical guidelines for hematological malignancies, 2018: III. Myeloma-1. Multiple myeloma (MM)","volume":"109","author":"S Iida","year":"2019","journal-title":"Int J Hematol"},{"key":"pone.0285947.ref002","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1053\/j.seminoncol.2019.03.001","article-title":"State of the science in smoldering myeloma: Should we be treating in the clinic?","volume":"46","author":"E Hill","year":"2019","journal-title":"Semin Oncol"},{"key":"pone.0285947.ref003","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s12185-020-02841-w","article-title":"Latest treatment strategies aiming for a cure in transplant-eligible multiple myeloma patients: how I cure younger MM patients with lower cost","volume":"111","author":"K. Suzuki","year":"2020","journal-title":"Int J Hematol"},{"key":"pone.0285947.ref004","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1038\/leu.2013.313","article-title":"Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients","volume":"28","author":"SK Kumar","year":"2014","journal-title":"Leukemia"},{"key":"pone.0285947.ref005","doi-asserted-by":"crossref","first-page":"1915","DOI":"10.1038\/leu.2016.380","article-title":"Trends in overall survival and costs of multiple myeloma, 2000\u20132014","volume":"31","author":"R Fonseca","year":"2017","journal-title":"Leukemia"},{"key":"pone.0285947.ref006","doi-asserted-by":"crossref","first-page":"3412","DOI":"10.1200\/JCO.2005.04.242","article-title":"International staging system for multiple myeloma","volume":"23","author":"PR Greipp","year":"2005","journal-title":"J Clin Oncol"},{"key":"pone.0285947.ref007","doi-asserted-by":"crossref","first-page":"e349","DOI":"10.1038\/bcj.2015.79","article-title":"Trends of survival in patients with multiple myeloma in Japan: a multicenter retrospective collaborative study of the Japanese Society of Myeloma","volume":"5","author":"S Ozaki","year":"2015","journal-title":"Blood Cancer J"},{"key":"pone.0285947.ref008","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1002\/1097-0142(197509)36:3<842::AID-CNCR2820360303>3.0.CO;2-U","article-title":"A clinical staging system for multiple myeloma. Correlation of measured myeloma mass with presenting clinical features, response to treatment, and survival","volume":"36","author":"BG Durie","year":"1975","journal-title":"Cancer"},{"key":"pone.0285947.ref009","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1038\/bjc.1979.94","article-title":"Misonidazole and MTDQ in combination: cytotoxic and radiosensitizing properties in hypoxic mammalian cells","volume":"39","author":"M Astor","year":"1979","journal-title":"Br J Cancer"},{"key":"pone.0285947.ref010","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/j.1365-2141.1983.tb02158.x","article-title":"Serum \u03b22-microglobulin and survival duration in multiple myeloma: a simple reliable marker for staging","volume":"55","author":"R Bataille","year":"1983","journal-title":"Br J Haematol"},{"key":"pone.0285947.ref011","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S0140-6736(78)91428-9","article-title":"\u03b22-microglobulin, a tumour marker of lymphoproliferative disorders","volume":"2","author":"JP Cassuto","year":"1978","journal-title":"Lancet"},{"key":"pone.0285947.ref012","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1182\/blood.V75.4.823.823","article-title":"Prognostic value of pretreatment serum \u03b22 microglobulin in myeloma: a Southwest Oncology Group Study","volume":"75","author":"BG Durie","year":"1990","journal-title":"Blood"},{"key":"pone.0285947.ref013","doi-asserted-by":"crossref","first-page":"2863","DOI":"10.1200\/JCO.2015.61.2267","article-title":"Revised International Staging System for multiple myeloma: a report from International Myeloma Working Group","volume":"33","author":"A Palumbo","year":"2015","journal-title":"J Clin Oncol"},{"key":"pone.0285947.ref014","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1007\/s00277-019-03702-1","article-title":"Evaluation of the Revised International Staging System (R-ISS) in Japanese patients with multiple myeloma","volume":"98","author":"S Ozaki","year":"2019","journal-title":"Ann Hematol"},{"key":"pone.0285947.ref015","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/bjh.16139","article-title":"Development of a prognostic model for overall survival in multiple myeloma using the Connect(\u00ae) MM Patient Registry","volume":"187","author":"HR Terebelo","year":"2019","journal-title":"Br J Haematol"},{"key":"pone.0285947.ref016","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1634\/theoncologist.2016-0104","article-title":"Analysis of real-world data on overall survival in multiple myeloma patients with \u22653 prior lines of therapy including a proteasome inhibitor (PI) and an immunomodulatory drug (IMiD), or double refractory to a PI and an IMiD","volume":"21","author":"S Usmani","year":"2016","journal-title":"Oncologist"},{"key":"pone.0285947.ref017","doi-asserted-by":"crossref","first-page":"5866","DOI":"10.1002\/cam4.4137","article-title":"Front-line treatment patterns in multiple myeloma: an analysis of U.S.-based electronic health records from 2011 to 2019","volume":"10","author":"S Kumar","year":"2021","journal-title":"Cancer Med"},{"key":"pone.0285947.ref018","unstructured":"Japanese Society for Pharmacoepidemiology (JSPE). Inventory of Japanese databases for clinical- and pharmaco-epidemiology researches. v1.0. 2020. Available at: https:\/\/sites.google.com\/view\/jspedatabaseindex\/home. Accessed March 10, 2022."},{"key":"pone.0285947.ref019","unstructured":"Japanese Society for Pharmacoepidemiology (JSPE). Database overview. RWD database. 2022. Available at: https:\/\/sites.google.com\/view\/jspedatabaseindex\/hceirwd. Accessed March 10, 2022."},{"key":"pone.0285947.ref020","unstructured":"Real World Data Co. About us. Available at: https:\/\/rwdata.co.jp\/about\/. Accessed March 10, 2022."},{"key":"pone.0285947.ref021","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0962280206074463","article-title":"Multiple imputation of discrete and continuous data by fully conditional specification","volume":"16","author":"S. van Buuren","year":"2007","journal-title":"Stat Methods Med Res"},{"key":"pone.0285947.ref022","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1186\/s12874-017-0404-7","article-title":"Methods for significance testing of categorical covariates in logistic regression models after multiple imputation: power and applicability analysis","volume":"17","author":"I Eekhout","year":"2017","journal-title":"BMC Med Res Methodol"},{"key":"pone.0285947.ref023","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1471-2288-9-57","article-title":"Combining estimates of interest in prognostic modelling studies after multiple imputation: current practice and guidelines","volume":"9","author":"A Marshall","year":"2009","journal-title":"BMC Med Res Methodol"},{"key":"pone.0285947.ref024","doi-asserted-by":"crossref","first-page":"3178","DOI":"10.1002\/sim.5384","article-title":"A maximally selected test of symmetry about zero","volume":"31","author":"E Laska","year":"2012","journal-title":"Stat Med"},{"key":"pone.0285947.ref025","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.clml.2016.06.001","article-title":"Revised International Staging System applied to real world multiple myeloma patients","volume":"16","author":"VH Jimenez-Zepeda","year":"2016","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"pone.0285947.ref026","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.bbrc.2005.05.204","article-title":"Rebamipide inhibits gastric cancer growth by targeting survivin and Aurora-B","volume":"334","author":"A Tarnawski","year":"2005","journal-title":"Biochem Biophys Res Commun"},{"key":"pone.0285947.ref027","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1038\/nrc1502","article-title":"Aurora-kinase inhibitors as anticancer agents","volume":"4","author":"N Keen","year":"2004","journal-title":"Nat Rev Cancer"},{"key":"pone.0285947.ref028","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1182\/blood-2007-06-097774","article-title":"The centrosome index is a powerful prognostic marker in myeloma and identifies a cohort of patients that might benefit from aurora kinase inhibition","volume":"111","author":"WJ Chng","year":"2008","journal-title":"Blood"},{"key":"pone.0285947.ref029","doi-asserted-by":"crossref","first-page":"4331","DOI":"10.1182\/blood-2008-09-178350","article-title":"Inhibition of aurora kinases for tailored risk-adapted treatment of multiple myeloma","volume":"113","author":"D Hose","year":"2009","journal-title":"Blood"},{"key":"pone.0285947.ref030","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/bjh.17350","article-title":"Real-world outcomes with bortezomib-containing regimens and lenalidomide plus dexamethasone for the treatment of transplant-ineligible multiple myeloma: a multi-institutional report from the Canadian Myeloma Research Group database","volume":"193","author":"VH Jimenez-Zepeda","year":"2021","journal-title":"Br J Haematol"},{"key":"pone.0285947.ref031","doi-asserted-by":"crossref","first-page":"3459","DOI":"10.1200\/JCO.2014.60.2466","article-title":"Continuous therapy versus fixed duration of therapy in patients with newly diagnosed multiple myeloma","volume":"33","author":"A Palumbo","year":"2015","journal-title":"J Clin Oncol"},{"key":"pone.0285947.ref032","article-title":"National Cancer Center Japan","year":"2021","journal-title":"Clinical laboratory reference values"},{"key":"pone.0285947.ref033","article-title":"National Cancer Center Japan","year":"2021","journal-title":"Clinical trials and clinical trials of new drugs (for client companies) information"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285947","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T17:54:42Z","timestamp":1685555682000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285947"}},"subtitle":[],"editor":[{"given":"Yasunori","family":"Sato","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,5,31]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0285947","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,31]]}}}