{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:01:49Z","timestamp":1792530109367,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gemeinn\u00fctziger Verein zur F\u00f6rderung von klinischen Registern und Versorgungsforschung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for \u22655 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous stem cell transplantation (SCT, transplant eligible = TE)) with primarily VRd (Bortezomib\/Lenalidomide\/Dexamethasone) given as induction (26.5%), followed by lenalidomide maintenance in 55.7% of cases. Transplant-ineligible (NTE) patients were predominantly treated with Vd (Bortezomib\/Dexamethasone, 21.6%), receiving maintenance in 27.1%. A total of 37.5% received a second LoT. ARs across one to five LoTs were 16.7\u201327%. Frontline induction\/ SCT followed by maintenance reduced ARs associated with age and achievement of deep remission in the frontline. Deep remission prolongs follow-up and time-to-next-treatment (TTNT), while high-risk-cyctogenetics negatively affected these outcomes. Our results demonstrate considerably lower ARs for MM patients within the AMR data versus other healthcare systems. Young age and the achievement of significant remissions after optimal frontline therapy resulted in particularly low ARs. These promising results support a key role for the ease of drug access and reimbursement policies in governing long-term MM patient outcomes.<\/jats:p>","DOI":"10.3390\/cancers15030962","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T03:36:57Z","timestamp":1675395417000},"page":"962","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Attrition Rates in Multiple Myeloma Treatment under Real World Conditions\u2014An Analysis from the Austrian Myeloma Registry (AMR)"],"prefix":"10.3390","volume":"15","author":[{"given":"Magdalena A.","family":"Benda","sequence":"first","affiliation":[{"name":"Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria"},{"name":"Private University of the Principality of Liechtenstein, 9495 Triesen, Principality of Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-1002","authenticated-orcid":false,"given":"Hanno","family":"Ulmer","sequence":"additional","affiliation":[{"name":"Institute of Medical Statistics and Informatics, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Weger","sequence":"additional","affiliation":[{"name":"Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria"},{"name":"syndena GmbH, Connect to Cure, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Reimann","sequence":"additional","affiliation":[{"name":"Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria"},{"name":"Private University of the Principality of Liechtenstein, 9495 Triesen, Principality of Liechtenstein"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresia","family":"Lang","sequence":"additional","affiliation":[{"name":"Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Pichler","sequence":"additional","affiliation":[{"name":"Internal Medicine I: Hematology, Oncology, Nephrology & Endocrinology St. P\u00f6lten, Medical University of St. P\u00f6lten, 3100 St. P\u00f6lten, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Winder","sequence":"additional","affiliation":[{"name":"Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8831-3746","authenticated-orcid":false,"given":"Bernd","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Internal Medicine II: Oncology, Hematology, Gastroenterology, Infectiology, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9649-5850","authenticated-orcid":false,"given":"Irene","family":"Strassl","sequence":"additional","affiliation":[{"name":"Division of Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Department of Internal Medicine I, Ordensklinikum Linz, Fadingerstrasse 1 and Seilerst\u00e4tte 4, 4020 Linz, Austria"},{"name":"Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Theresa","family":"Krauth","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division Hematology & Hemostaseology, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermine","family":"Agis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division Hematology & Hemostaseology, Medical University Vienna, 1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Sormann","sequence":"additional","affiliation":[{"name":"Internal Medicine, Division of Hematology, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Podar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Krems, and Molecular Oncology and Hematology Unit, Karl Landsteiner University of Health Sciences, 3500 Krems an der Donau, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Willenbacher","sequence":"additional","affiliation":[{"name":"Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria"},{"name":"syndena GmbH, Connect to Cure, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2853-5405","authenticated-orcid":false,"given":"Ella","family":"Willenbacher","sequence":"additional","affiliation":[{"name":"Internal Medicine V: Haematology & Oncology, Medical University of Innsbruck, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.annonc.2020.11.014","article-title":"Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and 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