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. 2016 Aug 8:16:613.
doi: 10.1186/s12885-016-2645-y.

Risk factors associated with early mortality in patients with multiple myeloma who were treated upfront with a novel agents containing regimen

Sung-Hoon Jung  1 , Min-Seok Cho  1 , Hee Kyung Kim  2 , Seok Jin Kim  2 , Kihyun Kim  3 , June-Won Cheong  4 , Soo-Jeoong Kim  4 , Jin Seok Kim  4 , Jae-Sook Ahn  1 , Yeo-Kyeoung Kim  1 , Deok-Hwan Yang  1 , Hyeoung-Joon Kim  1 , Je-Jung Lee  5 ; Korean Multiple Myeloma Working Party (KMMWP)
Affiliations

Risk factors associated with early mortality in patients with multiple myeloma who were treated upfront with a novel agents containing regimen

Sung-Hoon Jung et al. BMC Cancer. .

Abstract

Background: Although the introduction of novel agents improved the survival outcomes in patients with multiple myeloma (MM), some patients died within one year (early mortality, EM) following diagnosis. In this study, we evaluated the EM rate, and investigated the risk factors associated with EM in MM patients.

Methods: Retrospective data from 542 patients who were initially treated with a novel agent-containing regimen were analyzed.

Results: The median overall survival (OS) for the entire cohort was 56.5 months. The median OS in the 2010-2014 group was longer than in the 2002-2009 group (59.2 months vs. 49.1 months, P = 0.054). The rate of EM was 13.8 %, and the most common causes of EM were infection and comorbidity. In multivariate analysis, the age-adjusted Charlson comorbidity index (ACCI ≥ 4), low body mass index (BMI < 20 kg/m(2)), thrombocytopenia, and renal failure were significantly associated with EM. The presence of none, 1, or ≥ 2 factors was associated with a 4.1 %, 14.3 %, or 27.4 % risk of EM (P < 0.001), respectively. The median OS times were significantly different depending on the presence of factors associated with EM (P < 0.001).

Conclusions: In conclusion, the ACCI (≥ 4), low BMI, thrombocytopenia and renal failure were strong predictors for EM in the novel agent era. The results of this study will help to identify patients at high risk for EM, and may be helpful to more accurately predict prognosis of MM patients in the novel-agent era.

Keywords: Comorbidity; Early mortality; Multiple myeloma; Thrombocytopenia.

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Figures

Fig. 1
Fig. 1
a Kaplan-Meier survival curves for overall survival (OS) in all patients. b OS according to age. c OS according to the period of diagnosis. d OS comparison between patients receiving an autologous stem cell transplantation (ASCT) versus those who did not receive ASCT0
Fig. 2
Fig. 2
Kaplan-Meier survival curves for overall survival (OS) according to a age-adjusted Charlson Comorbidity Index (ACCI) 4, b body mass index (BMI) 20 kg/m2, c cytogenetic risk, and d international staging system (ISS)
Fig. 3
Fig. 3
Etiologies of EM
Fig. 4
Fig. 4
a EM rate and b OS according to number of risk factors
See this image and copyright information in PMC

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