Aim. The primary objective of the interim analysis of the MULTISPECT study was to evaluate the short-term efficacy of the treatment and long-term outcomes in cohorts of primary and pretreated patients with multiple myeloma (MM) receiving treatment in actual clinical practice in various regions of the Russian Federation. Secondary objectives were a description of the main characteristics of patients; analysis of the most commonly used therapy regimens of the 1st and later lines and the sequence of their changes; evaluation of the response to therapy. Additional objectives included evaluation of the effect of the new COVID-19 coronavirus infection on the course of MM in patients. Materials and methods. The study is an observational retrospective-prospective multicenter cohort study. For its implementation, a structured database of patients with MM was used, provided by hematologists of the centers affiliated for the study. Results. The study included 1,294 patients (cohort 1 806, cohort 2 488). In both cohorts, patients aged 6069 years were in the majority. 3 lines of therapy (L1, L2, L3) were used for cohort 1; in cohort 2, the 4th line of therapy was also used in 2 patients. The therapy regimens were analyzed for 290 (22.41%) of all patients in the study. Responses to therapy were analyzed for 214 patients of cohort 1 and 109 patients of cohort 2. Autologous and allogeneic hematopoietic stem cell transplantations were carried out for a limited proportion of patients in both cohorts. At the end of the study and upon presentation of its results, the status of patients was the following: 96% of patients in cohort 1 and 89% in cohort 2 were alive. The therapy regimens in both cohorts were characterized by variability. The most commonly used regimens in each of the lines of therapy have been identified. The most used therapy regimen in patients with MM of both cohorts was the VCD-regime. Rd-regime in cohort 1 and RD-regime in cohort 2 were the second most frequent used regimens. In patients of both cohorts, the therapy regimens including Bortezomib were most often used. Conclusion. The variety of therapy regimens used to treat MM in actual clinical practice may be due to the factors of availability of new medicines and updated recommendations for the treatment of the disease. Further, in the context of this study, a more detailed analysis of the efficacy of certain therapy regimens in the 1st and later lines on progression free survival and overall survival of MM patients should be carried out.

Introduction . Before the introduction of targeted agents, multiple myeloma (MM) was characterized by low overall survival (OS) rates. Survival during the first year of life is a clear indicator of the effectiveness of not only antitumor therapy but also accompanying therapy. Analysis of the cause of death in the MM patient population will allow for refined approaches to diagnosis, antitumor treatment, and accompanying therapy. Aim : to determine the one-year OS rates in patients with newly diagnosed MM, to study the cause of death, and to estimate the probability of death within the first year after diagnosis. Materials and Methods . This multicenter prospective study, conducted from January 2015 to October 2018, included 3,184 patients (1,339 men and 1,845 women) with newly diagnosed MM from 40 regions of Russia, aged 24–90 years. One-year OS, one-year mortality, and causes of death were analyzed. Results . During the follow-up period, 2,307 deaths were recorded, 261 patients were lost to follow-up, and 616 patients continue to receive antitumor therapy or remain untreated. The median OS of patients with MM was 44 months, with a 5-year OS probability of 40 % and a 10-year OS probability of 17 %. Among 2,307 patients with documented fatal outcomes, causes of death were available in 1,350 cases. In 55.7 % (n = 752) of cases, death was determined to be due to MM progression, in 19 % (n = 257) to infectious complications, in 8.2 % (n = 111) to acute cardiovascular failure, and in 4 % (n = 54) to acute kidney injury. Pulmonary embolism was documented in 3.6 % of patients (n = 49), and mesenteric vascular thrombosis was diagnosed in 0.3 % (n = 4) of cases. Acute cerebrovascular accident, both ischemic and hemorrhagic, was diagnosed in 3.7 % (n = 50) of cases resulting in death. A second malignancy was the primary cause of death in 1.6 % (n = 22) of patients with MM. The one-year OS rate for patients newly diagnosed with myeloma from 2015 to 2018 was 82 %. The 5-year probability of death from myeloma progression was 31 %, while the 1-year probability was 9 %. Meanwhile, the 5-year probability of death from causes unrelated to myeloma progression was 45 %, while the 1-year probability was 11 %. Conclusion . The probability of death from causes unrelated to refractory myeloma was comparable across all age cohorts. This highlights the need for knowledge regarding concomitant therapy and the correction of comorbid factors. Differences in the one-year OS of patients with myeloma were demonstrated depending on the registration center, due to differences in access to second- and subsequent-line anticancer drugs. It is important to note the need to develop a separate treatment strategy for the cohort of patients with myeloma diagnosed in old age.