{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:18:32Z","timestamp":1790781512897,"version":"4.1.0"},"reference-count":45,"publisher":"SAABRON PRESS","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Multiple myeloma (MM) treatment outcomes in developing countries may be impacted by resource constraints. This systematic review and meta-analysis evaluated efficacy outcomes of MM treatments across developing regions. Comprehensive searches in five major databases identified 37 eligible studies from Asia, Africa, Latin America, and Eastern Europe. The Newcastle-Ottawa Scale was used to assess risk of bias. Newer novel agents including daratumumab, carfilzomib, and pomalidomide showed limited use across studies. For patients receiving autologous stem cell transplantation (ASCT), the pooled overall survival rate at longest follow-up (2.5-12.5 years) was 62% (95% CI: 48-75%), with high heterogeneity (I\u00b2=92%), while the progression-free survival rate at longest follow-up (3-8 years) was 44% (95% CI: 23-67%). Comparative analyses demonstrated ASCT was associated with significantly superior 5-year survival compared to conventional chemotherapy (RR: 1.59; 95% CI: 1.38-1.82). Bortezomib-based regimens showed better outcomes than thalidomide-based therapies (HR for overall survival (OS) at 4 years: 0.73; 95% CI: 0.53-1.0) and alkylating agent-based regimens (HR: 0.48; 95% CI: 0.28-0.83). Despite resource limitations, ASCT and certain novel agents are associated with improved survival outcomes for MM patients in developing countries. However, substantial heterogeneity in outcomes suggests variability in healthcare infrastructure, treatment accessibility, and clinical expertise across these regions.<\/jats:p>","DOI":"10.46989\/001c.144582","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T14:17:06Z","timestamp":1759933026000},"source":"Crossref","is-referenced-by-count":3,"title":["Treatment Outcomes of Multiple Myeloma in Developing Countries: A Systematic Review and Meta-Analysis"],"prefix":"10.46989","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6098-8450","authenticated-orcid":false,"given":"Jehad","family":"Almasri","sequence":"first","affiliation":[{"name":"University of Cincinnati Cancer Center, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9531-4990","authenticated-orcid":false,"given":"Bashar","family":"Hasan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02qp3tb03","id-type":"ROR","asserted-by":"publisher"}],"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zin","family":"Tarakji","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02qp3tb03","id-type":"ROR","asserted-by":"publisher"}],"name":"Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7069-6424","authenticated-orcid":false,"given":"Faris W.","family":"Naffa\u2019","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Ascension Saint Agnes, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6789-413X","authenticated-orcid":false,"given":"Lynn","family":"Warner","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01e3m7079","id-type":"ROR","asserted-by":"publisher"}],"name":"Health Science Library, University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Mian","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02fa3aq29","id-type":"ROR","asserted-by":"publisher"}],"name":"McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajshekhar","family":"Chakraborty","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00hj8s172","id-type":"ROR","asserted-by":"publisher"}],"name":"Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-783X","authenticated-orcid":false,"given":"Ghulam Rehman","family":"Mohyuddin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03r0ha626","id-type":"ROR","asserted-by":"publisher"}],"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Abdel-Rahman","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0564xsr50","id-type":"ROR","asserted-by":"publisher"}],"name":"King Hussein cancer center, Amman, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4297-8042","authenticated-orcid":true,"given":"Samer","family":"Al Hadidi","sequence":"additional","affiliation":[{"name":"Myeloma Center, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26435","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"issue":"3","key":"ref1","first-page":"S168","article-title":"Bone marrow versus non-cryopreserved peripheral blood stem cell transplantation for multiple myeloma: A systematic review and meta-analysis","volume":"22","author":"S.K. Kumar","year":"2016","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref2","first-page":"1365","article-title":"Clinical outcomes of multiple myeloma patients treated with cyclophosphamide, thalidomide and dexamethasone at a national reference center in Lima, Peru","volume":"7","author":"L. 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Bekadja","year":"2015","journal-title":"Hematology\/Oncology and Stem Cell Therapy"},{"issue":"2","key":"ref22","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis","volume":"8","author":"M. Arbyn","year":"2017","journal-title":"The Lancet Global Health"},{"issue":"1","key":"ref23","first-page":"8","article-title":"Results of autologous stem cell transplantation in multiple myeloma: A single-center experience in Algeria","volume":"9","author":"M. A. Bekadja","year":"2016","journal-title":"Hematology\/Oncology and Stem Cell Therapy"},{"issue":"9","key":"ref24","first-page":"2","article-title":"Characteristics and outcomes of patients with multiple myeloma: Data from a developing country","volume":"29","author":"A. 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Forest plot showing individual studies and the pooled estimate with 95% confidence interval"}],"container-title":["Clinical Hematology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/chi.scholasticahq.com\/article\/144582-treatment-outcomes-of-multiple-myeloma-in-developing-countries-a-systematic-review-and-meta-analysis","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:47:18Z","timestamp":1788382038000},"score":1,"resource":{"primary":{"URL":"https:\/\/chi.scholasticahq.com\/article\/144582-treatment-outcomes-of-multiple-myeloma-in-developing-countries-a-systematic-review-and-meta-analysis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.46989\/001c.144582","relation":{},"ISSN":["2590-0048"],"issn-type":[{"value":"2590-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,8]]}}}