Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 6;23(1):317.
doi: 10.1186/s12885-023-10787-5.

Time trends in survival and causes of death in multiple myeloma: a population-based study from Germany

Christine Eisfeld  1   2 , Hiltraud Kajüter  3 , Lennart Möller  3 , Ina Wellmann  3 , Evgenii Shumilov  4 , Andreas Stang  3   5   6
Affiliations

Time trends in survival and causes of death in multiple myeloma: a population-based study from Germany

Christine Eisfeld et al. BMC Cancer. .

Abstract

Background: Steady evolution of therapies has improved prognosis of patients with multiple myeloma (MM) over the past two decades. Yet, knowledge about survival trends and causes of death in MM might play a crucial role in long-term management of this patient collective. Here, we investigate time trends in myeloma-specific survival at the population level over two decades and analyse causes of death in times of prolonged survival.

Methods: Age-standardised and age group-specific relative survival (RS) of MM patients aged < 80 years at diagnosis was estimated for consecutive time periods from 2000-2019 using data from the Cancer Registry of North Rhine-Westphalia in Germany. Conditional RS was estimated for patients who already survived one to five years post diagnosis. Causes of death in MM patients were analysed and compared to the general population using standardised mortality ratios (SMR).

Results: Three thousand three hundred thirty-six MM cases were included in the time trend analysis. Over two decades, age-standardised 5-year RS increased from 37 to 62%. Age-specific survival improved from 41% in period 2000-2004 to 69% in period 2015-2019 in the age group 15-69 years, and from 23 to 47% in the age group 70-79 years. Conditional 5-year RS of patients who survived five years after diagnosis slightly improved as compared to unconditional 5-year RS at diagnosis. MM patients are two times more likely to die from non-myeloma malignancies (SMR = 1.97, 95% CI 1.81-2.15) and from cardiovascular diseases (SMR = 2.01, 95% CI 1.86-2.18) than the general population.

Conclusions: Prognosis of patients with MM has markedly improved since the year 2000 due to therapeutic advances. Nevertheless, late mortality remains a major concern. As survival improves, second primary malignancies and cardiovascular events deserve increased attention.

Keywords: Causes of death; Conditional Survival; Germany; Multiple Myeloma; Registries; Relative Survival; Survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Age-specific and age-standardised 5-year relative survival for patients with multiple myeloma. Patients diagnosed 1995–2019 living in the administrative district of Münster were included. Error bars indicate 95% confidence intervals
Fig. 2
Fig. 2
Five-year conditional relative survival of patients with multiple myeloma. Patients diagnosed 2010–2019 living in North Rhine-Westphalia were included. Error bars indicate 95% confidence intervals
See this image and copyright information in PMC

References

    1. Zentrum für Krebsregisterdaten im Robert Koch-Institut (RKI). Krebs in Deutschland für 2017/2018. RKI und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V., editors. 13th ed. Berlin: Publishername-Zentrum für Krebsregisterdaten im Robert Koch-Institut (RKI); 2021. p. 138–141.
    1. Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor I, Curado MP, et al. Global burden of multiple myeloma: a systematic analysis for the global burden of disease study 2016. Jama Oncol. 2018;4:1221–1227. doi: 10.1001/jamaoncol.2018.2128. - DOI - PMC - PubMed
    1. Huang J, Chan SC, Lok V, Zhang L, Lucero-Prisno DE, Xu W, et al. The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. Lancet Haematol. 2022;9(9):e670–e677. doi: 10.1016/S2352-3026(22)00165-X. - DOI - PubMed
    1. Piechotta V, Jakob T, Langer P, Monsef I, Scheid C, Estcourt LJ, et al. Multiple drug combinations of bortezomib, lenalidomide, and thalidomide for first‐line treatment in adults with transplant‐ineligible multiple myeloma: a network meta‐analysis. Cochrane Db Syst Rev. 2019;(11). 10.1002/14651858.CD013487, https://training.cochrane.org/resource/how-cite-cochrane-publications. - PMC - PubMed
    1. Costa LJ, Brill IK, Omel J, Godby K, Kumar SK, Brown EE. Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States. Blood Adv. 2017;1:282–287. doi: 10.1182/bloodadvances.2016002493. - DOI - PMC - PubMed