A real-world data analysis of predictors of early mortality after a diagnosis of multiple myeloma
Menée aux Etats-Unis à partir de données portant sur 7 512 patients atteints d'un myélome multiple diagnostiqué entre 2011 et 2021 (âge médian : 70 ans), cette étude identifie les facteurs associés au risque de décès précoce
Background : Despite the increased availability and use of novel therapies for multiple myeloma, early mortality is a pervasive challenge with a significant impact on older adults. Reported rates and predictors of early mortality have varied in the literature, with most studies seldom focusing on community-treated patients.
Methods : In this retrospective cohort analysis of a real-world electronic health record–derived deidentified database of 7512 patients newly diagnosed with multiple myeloma between January 1, 2011, and February 2, 2021, and treated primarily in US-based community oncology practices, factors associated with early mortality (defined as death within 6 months after the multiple myeloma diagnosis) were examined with the use of binary logistic regression.
Results : The median age was 70 years overall. We found an overall early mortality rate of 8.3%, with 73% of early deaths occurring in those aged
≥
70 years. Among the early deaths, only 49 patients (8.7%) had documented disease progression before death (median time to progression, 30 days [interquartile range, 7–53 days]). Baseline factors associated with higher odds of early mortality included an Eastern Cooperative Oncology Group performance status (ECOG PS)
≥
2, Revised International Staging System (R-ISS) stage III, an age
≥
70 years, receipt of proteasome inhibitor–doublet therapy, a light-chain isotype, and the presence of renal dysfunction (estimated glomerular filtration rate < 30 mL/min). Among those aged
≥
70 years, ECOG PS
≥
2 and R-ISS stage III remained the strongest predictors of early mortality.
Conclusions : Early mortality disproportionately affects older adults (aged
≥
70 years) with multiple myeloma. Interventions to support this population are needed to reduce disparate survival outcomes.
Cancer , résumé, 2022