Abstract:
Treatment patterns and survival outcomes of patients with multiple myeloma (MM) in Kenya have not
been adequately characterized. The objectives of this study were to describe the clinical, laboratory, and imaging
findings at diagnosis, to describe the treatment offered, and to determine the survival outcomes of patients with
MM over an 11-year period.
PATIENTS AND METHODS A retrospective chart review was carried out for all patients who were diagnosed and
treated for MM at Moi Teaching and Referral Hospital from 2009 to 2019. The Kaplan-Meier method was used to
estimate survival. Factors affecting survival were identified using univariate and multivariate analyses.
RESULTS A total of 221 patient charts were analyzed of which 124 belonged to male patients (56.1%). The
median age at diagnosis was 61 years. Bone pain was the most common presenting complaint observed in
69.6% of 194 patients assessed. Out of 102 patients who received imaging studies, 60 (58.8%) had lytic lesions,
30 (29.4%) had fractures, whereas 30 (29.4%) had spinal cord compression. Anemia, renal failure, and
hypercalcemia were observed in 87/187 (46.5%), 22/161 (13.7%), and 23/42 (54.8%) patients, respectively.
Thalidomide and dexamethasone (65.2%); bortezomib, thalidomide, and dexamethasone (14.6%); and
melphalan and prednisolone (11.9%) were the most prescribed initial chemotherapy regimens among 219
patients analyzed. Overall survival at 1 and 5 years was 70% and 21%, respectively; median overall survival was
29.0 months. In multivariate analysis, male sex (hazard ratio [HR] 1.9), baseline anemia (HR 1.8), and baseline
renal failure (HR 3.2) were associated with significantly shorter survival.
CONCLUSION Survival outcomes were poor despite increased use of multiagent-based chemotherapy regimens.
Greater access to available diagnostics and treatments is required to achieve rational treatment and increased survival.
