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Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma

The overall survival of patients with multiple myeloma (MM) has been improved greatly over the last 2 decades with the broader use of novel drugs and autologous tandem transplantation. However, more than one tenth of myeloma patients still die shortly after diagnosis. We therefore aim to investigate...

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Autores principales: Hsu, Pei, Lin, Ting-Wei, Gau, Jyh-Pyng, Yu, Yuan-Bin, Hsiao, Liang-Tsai, Tzeng, Cheng-Hwai, Chen, Po-Min, Chiou, Tzeon-Jye, Liu, Jin-Hwang, Liu, Yao-Chung, Liu, Chia-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058940/
https://www.ncbi.nlm.nih.gov/pubmed/26683968
http://dx.doi.org/10.1097/MD.0000000000002305
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author Hsu, Pei
Lin, Ting-Wei
Gau, Jyh-Pyng
Yu, Yuan-Bin
Hsiao, Liang-Tsai
Tzeng, Cheng-Hwai
Chen, Po-Min
Chiou, Tzeon-Jye
Liu, Jin-Hwang
Liu, Yao-Chung
Liu, Chia-Jen
author_facet Hsu, Pei
Lin, Ting-Wei
Gau, Jyh-Pyng
Yu, Yuan-Bin
Hsiao, Liang-Tsai
Tzeng, Cheng-Hwai
Chen, Po-Min
Chiou, Tzeon-Jye
Liu, Jin-Hwang
Liu, Yao-Chung
Liu, Chia-Jen
author_sort Hsu, Pei
collection PubMed
description The overall survival of patients with multiple myeloma (MM) has been improved greatly over the last 2 decades with the broader use of novel drugs and autologous tandem transplantation. However, more than one tenth of myeloma patients still die shortly after diagnosis. We therefore aim to investigate the risk factors of early mortality (death within 60 days after diagnosis) in patients with MM. We included in this study 451 consecutive patients with MM, newly diagnosed at an Asian tertiary medical center between January 1, 2002 and April 30, 2015. A total of 57 subjects who experienced early mortality were identified. Risk factors for early mortality in myeloma patients were collected and analyzed. Early mortality occurred in 57 (12.6%) of the myeloma patients. In the multivariate analysis, being male (adjusted OR 2.93, 95% CI 1.17–7.31), serum albumin < 3.5 g/dL (adjusted OR 2.71, 95% CI 1.09–6.74), primary plasma cell leukemia (adjusted OR 17.61, 95% CI 1.01–306.05), serum albumin (adjusted OR 2.70, 95% CI 1.15–6.38), corrected serum calcium ≥ 12 mg/dL (adjusted OR 2.94, 95% CI 1.21–7.14), and LDH ≥ 250 U/L (adjusted OR 3.07, 95% CI 1.50–6.27) were identified as independent risk factors of early mortality. Pneumonia with other infections contributed most to early mortality (n = 36, 65%), followed by renal failure and cardiac failure. The early mortality rate is high (12.6%) in patients with MM. Patients who are male and those with primary plasma cell leukemia, low serum albumin, high-corrected serum calcium, or LDH are at risk of early mortality. Nearly two thirds of the myeloma patients who experienced early mortality in our study (37 of 57, 65%) died of infection. Once a high-risk group is identified, much effort is required to target new approaches for prevention, early detection, and treatment of infections.
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spelling pubmed-50589402016-11-01 Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma Hsu, Pei Lin, Ting-Wei Gau, Jyh-Pyng Yu, Yuan-Bin Hsiao, Liang-Tsai Tzeng, Cheng-Hwai Chen, Po-Min Chiou, Tzeon-Jye Liu, Jin-Hwang Liu, Yao-Chung Liu, Chia-Jen Medicine (Baltimore) 4800 The overall survival of patients with multiple myeloma (MM) has been improved greatly over the last 2 decades with the broader use of novel drugs and autologous tandem transplantation. However, more than one tenth of myeloma patients still die shortly after diagnosis. We therefore aim to investigate the risk factors of early mortality (death within 60 days after diagnosis) in patients with MM. We included in this study 451 consecutive patients with MM, newly diagnosed at an Asian tertiary medical center between January 1, 2002 and April 30, 2015. A total of 57 subjects who experienced early mortality were identified. Risk factors for early mortality in myeloma patients were collected and analyzed. Early mortality occurred in 57 (12.6%) of the myeloma patients. In the multivariate analysis, being male (adjusted OR 2.93, 95% CI 1.17–7.31), serum albumin < 3.5 g/dL (adjusted OR 2.71, 95% CI 1.09–6.74), primary plasma cell leukemia (adjusted OR 17.61, 95% CI 1.01–306.05), serum albumin (adjusted OR 2.70, 95% CI 1.15–6.38), corrected serum calcium ≥ 12 mg/dL (adjusted OR 2.94, 95% CI 1.21–7.14), and LDH ≥ 250 U/L (adjusted OR 3.07, 95% CI 1.50–6.27) were identified as independent risk factors of early mortality. Pneumonia with other infections contributed most to early mortality (n = 36, 65%), followed by renal failure and cardiac failure. The early mortality rate is high (12.6%) in patients with MM. Patients who are male and those with primary plasma cell leukemia, low serum albumin, high-corrected serum calcium, or LDH are at risk of early mortality. Nearly two thirds of the myeloma patients who experienced early mortality in our study (37 of 57, 65%) died of infection. Once a high-risk group is identified, much effort is required to target new approaches for prevention, early detection, and treatment of infections. Wolters Kluwer Health 2015-12-18 /pmc/articles/PMC5058940/ /pubmed/26683968 http://dx.doi.org/10.1097/MD.0000000000002305 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 4800
Hsu, Pei
Lin, Ting-Wei
Gau, Jyh-Pyng
Yu, Yuan-Bin
Hsiao, Liang-Tsai
Tzeng, Cheng-Hwai
Chen, Po-Min
Chiou, Tzeon-Jye
Liu, Jin-Hwang
Liu, Yao-Chung
Liu, Chia-Jen
Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title_full Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title_fullStr Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title_full_unstemmed Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title_short Risk of Early Mortality in Patients With Newly Diagnosed Multiple Myeloma
title_sort risk of early mortality in patients with newly diagnosed multiple myeloma
topic 4800
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058940/
https://www.ncbi.nlm.nih.gov/pubmed/26683968
http://dx.doi.org/10.1097/MD.0000000000002305
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