Projects

The MRDR has numerous investigator-initiated sub-studies and projects that address additional research questions. Researchers are from a variety of institutes and centres, with mixed backgrounds and levels of experience. The MRDR welcomes proposals for use of registry data and provides support as far as possible. All proposals must be reviewed and approved by the MRDR Steering Committee.

IMPROVE: Immunoglobulins in Myeloma Patients: Research into Outcomes, Variation in practice, and Epidemiology

Patients with myeloma are at risk of serious infection because of low levels of protective antibodies. Immunoglobulin therapy is used to replace missing antibodies to prevent or treat infections in patients with Myeloma. Immunoglobulin therapy is very expensive, more than $60 million dollars annually for this patient group, and blood cancers are the most common indication for its use in Australia, and with increasing demand. 

There is substantial variation in immunoglobulin use for this indication across Australia and the reason for this is unclear. Using the MRDR, this project will collect current ‘real world’ Australian clinical and laboratory information on immunoglobulin use to guide policy and clinical practice; to plan and deliver care; and to monitor practice, costs, and outcomes. We will also collect samples to store and test in future studies.

This study will also provide a new and lower cost framework for conducting future large clinical trials of immunoglobulin therapy in Australia in myeloma and similar conditions.

The study

IMPROVE is funded by the National Blood Authority and offers a $500 per patient payment for information on infection and immunoglobulin use in patients with MM. The target is 300 patients across all Australian MRDR sites. IMPROVE is an amendment to the MRDR and no further ethics or governance approval is required to participate. The IMPROVE blood biobank welcomes more participating sites in Victoria with a $200 additional per patient payment; a limited transport time restricts recruitment to within Victoria.

My-PROMPT: Patient Reported Outcome Measures in multiple myeloma: real-time rePorTing to improve care

Multiple myeloma (MM) is associated with a high burden of disease, compromising patients’ health-related quality of life (HRQOL). Patient reported outcome measures (PROM) are used to measure HRQOL. Whether incorporating PROM into routine care improves MM outcomes has not been studied. In order to design a clinical trial to evaluate impact of real-time PRO reporting on outcomes, feasibility and acceptability to clinicians and patients of delivering such an intervention needs to be evaluated.

The study

We performed a pilot, randomised controlled trial to assess the feasibility of real-time feedback of a PROM in newly diagnosed MM to treating clinicians. Thirty-two patients were enrolled. The intervention arm completed a disease-specific PROM (MyPOS) before 4 clinic visits: baseline, 1, 6 and 10 months. Treating clinicians were given a summary of MyPOS results before visits. The control arm completed MyPOS at baseline and 10 months. Evaluations of the intervention were completed by patients and clinicians and follow-up interviews were conducted. Primary feasibility outcomes were patient and clinician satisfaction scores for MyPOS use in the intervention. We have shown that the intervention is feasible and acceptable to patients and clinicians and are working towards a phase III clinical trial using a platform to deliver PRO results to clinicians at multiple sites across Australia with the support of Monash Helix. This study is in preparation for publication and is funded by Gilead and Takeda.

Renal Impairment at diagnosis in myeloma: an analysis of patient characteristics, treatment, and impact on outcomes

Researcher(s)

Prof Joy Ho, Clinical Professor and Senior staff specialist, Haematology, Royal Prince Alfred Hospital, Sydney

Progress

Published 2019 - Project complete

Rates of Upfront Autologous Stem Cell Transplantation (ASCT) in Newly Diagnosed Multiple Myeloma (NDMM): Comparing ASCT recipients and non-recipients

Researcher(s)

Dr Krystal Bergin, Consultant haematologist & PhD student, The Alfred Hospital, Melbourne

Progress

In progress

Pacific Islanders with MM in New Zealand compared to other ethnicities: characteristics, treatment and outcomes

Researcher(s)

A/Prof Hilary Blacklock, Consultant haematologist, Middlemore Hospital, Auckland, New Zealand

Progress

Presented at the International Myeloma Workshop 2019, Boston, USA and Blood 2019 in Perth. For publication

The Impact of Body Weight on Melphalan dosing in Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: Master's thesis topic

Researcher(s)

Dervla O'Ryan, Masters Student and Clinical Pharmacist, The Alfred Hospital, Melbourne

Progress

Masters thesis sucessfully completed - Project complete

Overview of imaging modalities in multiple myeloma - used for presentation on 18F-FDG-PET/CT to support uptake of the internationally preferred imaging modality in Australia

Researcher(s)

Dr Kylee McLachlan, Consultant Haematologist, Peter MacCallum Cancer Centre, Melbourne

Progress

Oral Presentation at Blood 2018 - Project complete

Predictors of early mortality in multiple myeloma: Results from the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR)

Researcher(s)

A/Prof Zoe McQuilten, School of Public Health and Preventive Medicine, Monash University (Consultant haematologist)

Progress

Submission for publication

Health-related quality of life at diagnosis in multiple myeloma: EQ-5D-5L results from the Myeloma and Related Diseases Registry and comparison with an Australian population norm

Researcher(s)

Dr Elizabeth Moore, Research Fellow, School of Public Health and Preventive Medicine, Monash University

Progress

Poster presentation at Blood 2018, to be worked up for publication

Analysis of bortezomib-based therapy in non-transplant eligible multiple myeloma

Researcher(s)

A/Prof Peter Mollee (Consultant haematologist) and Dr Stephen Boyle (Registrar), Princess Alexandra Hospital, Brisbane

Progress

Poster presentation at the International Myeloma Workshop in Boston, Sept 2019; for publication.

Analysis of recognition, timing, treatment and outcomes in patients with biochemical relapse post autologous stem cell transplant (ASCT)

Researcher(s)

A/Prof Hang Quach and Dr Matthew Ku, Consultant haematologists, St Vincent's Hospital, Melbourne

Progress

In preparation

Outcomes for melphlan / Velcade-based ASCT in high risk myeloma.

Researcher(s)

Dr David Routledge, Consultant Heamatologist, Peter MacCallum Cancer Centre, Melbourne

Progress

In preparation

Investigating C-terminal telopeptide 1 (CTX-1) as a marker of high risk for progressing to active MM in smouldering MM (SMM) patients.

Researcher(s)

Dr Kate Vandyke, Research Fellow, University of Adelaide

Progress

M1000 Biobank request - samples and data provided

Methylation biomarkers in plasma cell free DNA in myeloma

Researcher(s)

Prof Ian Morison, Professor of Pathology, Dunedin School of Medicine, University of Otago

Progress

Finalising M1000 Biobank request

Treatment patterns in relapsed / refractory MM in Australia

Researcher(s)

Dr Jessie Zhao, Registrar, Dorevitch Pathology, Melbourne

Progress

Oral presentation at Blood 2019 in Perth, Australia; for publication

Patterns of bone supportive care and the impact of antiresorptive therapy, vitamin D, and calcium levels on the clinical outcomes of patients with multiple myeloma in Australia

Researcher(s)

A/Prof Hang Quach, Consultant haematologist, St Vincent's Hospital, Melbourne

Progress

In preparation

Comparison of characteristics and outcomes of patients diagnosed with MM by traditional CRAB criteria versus "newer" biomarkers of malignancy (and high risk SMM using 20/20/20 criteria)

Researcher(s)

Prof Joy Ho, Clinical Professor and Senior staff specialist, Haematology, Royal Prince Alfred Hospital, Sydney

Progress

Defining question

Outcomes for patients with early progression or sub-optimal response in multiple myeloma in Australia and New Zealand

Researcher(s)

Prof Andrew Spencer, Head of Malignant Haematology & Stem Cell Transplantation Service, Alfred Health

Progress

For oral presentation at ASH Dec 2019, Orlando, USA

Regional outcomes in MM in Australia

Researcher(s)

Dr Louse Imlay, Lismore Hospital, NSW

Progress

Submitted for approval