• KerbauyLucila NassifLNMD. Attending Physician at the Oncology and Hematology Center Família Dayan-Daycoval, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Simrit Parmar, José Mauro Kutner, Breno Moreno de Gusmão, and Nelson Hamerschlak.
• MD. Attending Physician at the Oncology and Hematology Center Família Dayan-Daycoval, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
• Sao Paulo Med J. 2016 Jul 1; 134 (4): 335341335-41.

Context And ObjectiveFor the last nine years, hematologists and oncologists have gathered annually at an educational symposium organized by a Brazilian and an American hospital. During the 2015 Board Review, a survey among the attendees evaluated the differences in management and treatment methods for multiple myeloma (MM).Design And SettingCross-sectional study during an educational hematology symposium in São Paulo, Brazil.MethodsHematologists present at the symposium gave responses to an electronic survey by means of mobile phone.ResultsAmong the 350 attendees, 217 answered the questionnaire. Most of the participants believed that immunotargeting agents (iTA) might be effective for slowing MM progression in heavily pretreated patients (67%) and that continued exposure to therapy might lead to emergence of resistant clones in patients with MM (76%). Most of the physicians use maintenance therapy after hematopoietic stem cell transplantation (95%) and 45% of them would further restrict it to post-transplantation patients with underlying high-risk disease. The first-line drugs used for transplantation-ineligible patients (TI-MM) were bortezomib-thalidomide-dexamethasone (31%), bortezomib-dexamethasone (28%), lenalidomide-dexamethasone (Rd; 17%) and melphalan-based therapy (10%). Lenalidomide was the drug of choice for post-transplantation maintenance for half of the participants. No significant differences were observed regarding age or length of experience.ConclusionThe treatment choices for TI-MM patients were highly heterogenous and the melphalan-based regimen represented only 10% of the first-line options. Use of maintenance therapy after transplantation was a common choice. Some results from the survey were divergent from the evidence in the literature.

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