Multiple Myeloma Patients Treated at Higher-volume Facilities Have Better Outcomes, Study Finds

Patients treated for multiple myeloma at facilities that see a higher number of multiple myeloma patients annually had better outcomes compared to patients who were treated at lower-volume facilities, researchers at the Mayo Clinic found.

The research study, “Association Between Treatment Facility Volume and Mortality of Patients With Multiple Myeloma,” was published in the Journal of Clinical Oncology.

Studies have shown that facilities that perform a certain procedure more often or treat patients with a certain disease more frequently are associated with better clinical outcomes than those that perform the procedure fewer times or treat a lower number of patients with the disease.

Multiple myeloma is a rare blood cancer.  About 30,000 new cases are diagnosed annually in the United States. It makes up only 2% of all cancers. In multiple myeloma, plasma cells that make antibodies to help fight infections multiply abnormally and release too many antibodies that eventually build up and cause organ damage.

To determine the association of low- or high-volume facilities in relation to multiple myeloma, Ronald Go, MD, and his colleagues at the Mayo Clinic used the National Cancer Database to examine the outcome of 94,722 patients diagnosed with multiple myeloma from 2003 to 2011 at 1,333 centers.

The median age at diagnosis was 67 years; 54.7% of patients were men. The median follow-up was 57.6 months and the majority of patients (59.4%) were treated in non-academic facilities. Most facilities included in the study were non-academic (82.8%).

Results revealed that facility volume was independently associated with all-cause mortality. Compared to patients treated at high-volume facilities (40 new multiple myeloma patients annually), patients treated at low-volume facilities (10 new multiple myeloma patients annually) had a 20% higher risk of death.

“Studies on cancer surgery have shown the more experience the center or practitioner has, the better the outcome,” Go said in a news release. “It is very difficult to be proficient when doctors are seeing only one or two new cases of multiple myeloma per year. We wanted to see if volume matters when it comes to nonsurgical treatment of rare cancers such as multiple myeloma.”

The researchers had previously reported the findings at the American Society of Hematology 2015 Annual Meeting.