Early mortality high among multiple myeloma patients

Though decreasing over time, early mortality remains high in patients with multiple myeloma (MM), a recent study has found. Important risk factors include older age, a more aggressive disease, and a patient’s poor physical condition.

Drawing from the Netherlands Cancer Registry, the researchers followed patients newly diagnosed with MM from 1989–1998 (N=7,312), 1999–2008 (n=8,822), and 2009–2018 (n=12,194). Early mortality, the outcome, was defined as death by any cause ≤180 days after diagnosis.

Of the total 28,328 patients enrolled, 4,984 died ≤180 days post-diagnosis, yielding an early mortality rate of 18 percent relative to the entire patient population. Early death was more likely to occur in older patients but showed a downward trend with time across all age groups. For instance, the rate of early mortality was 40 percent in patients >80 years during the first period and decreased to 31 percent by the final period (p<0.01).

Indeed, calendar period emerged as a significant predictor of early mortality. Patients who were diagnosed from 2009–2018 were half as likely to die early than comparators diagnosed in 1989–1998.

Other important risk factors included old age (66–70 vs 18–65 years: hazard ratio [HR], 1.72, 95 percent confidence interval [CI], 1.29–2.30; >80 years: HR, 5.03, 95 percent CI, 3.93–6.43), thrombocytopaenia (HR, 1.76, 95 percent CI, 1.37–2.26), renal impairment (HR, 1.42, 95 percent CI, 1.21–1.67), and anaemia (HR, 1.17, 95 percent CI, 1.00–1.36), among others.