Vivek Kumar1, Meghna Ailawadhi2, Navnita Dutta3, Mays Abdulazeez2, Chander Shekher Aggarwal2, Gerson Quintero2, Mizba Baksh2, Vivek Roy2, Taimur Sher2, Victoria Alegria2, Aneel Paulus3, Asher Chanan-Khan4, Sikander Ailawadhi5. 1. Department of Medicine, Brigham and Women's Hospital/Dana Farber Cancer Institute Boston, Boston, MA. 2. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL. 3. Department of Cancer Biology, Mayo Clinic, Jacksonville, FL. 4. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL; Hematology-Oncology, St Vincent's Medical Center-Riverside, Jacksonville, FL. 5. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL; Department of Cancer Biology, Mayo Clinic, Jacksonville, FL. Electronic address: ailawadhi.sikander@mayo.edu.
Abstract
INTRODUCTION: Despite significant improvements in multiple myeloma (MM) treatment modalities, patient mortality early in the course of disease has been identified as a persistent phenomenon with variable reported rates and causes. Trends in early mortality over time have not been clearly defined. PATIENTS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database was used to identify adult patients with MM between 1975 and 2015. Association of available sociodemographic factors with all-cause and MM-specific early mortality (death within 6 months after the diagnosis of MM) was conducted by multivariate analysis. Trends in early mortality were studied by joinpoint regression analysis. RESULTS: Of the 90,975 MM cases included in this analysis, early mortality was noted in 21%. Median age was 68 years overall, and 75 years for the early mortality cohort (P < .01). The most common causes of death for early mortality were MM itself, followed by cardiovascular, infections, and renal failure. Male gender, "other" race/ethnicity group, advancing age, and West, Midwest or South regions (reference Northeast) were associated with increased risk of both all-cause and MM-specific early mortality. Joinpoint regression analysis of trends data resulted in 1 joinpoint for all-cause 6-month mortality (2006-2015), while 2 joinpoints were noticed for myeloma-specific 6-month mortality (1975-1987 and 2003-2015). CONCLUSION: Early mortality remains a significant unmet need for MM patient care, despite improving trends in recent years. Understanding the factors associated with early mortality can help develop individualized plans of patient care and mitigate circumstances that may contribute to early mortality among MM patients.
INTRODUCTION: Despite significant improvements in multiple myeloma (MM) treatment modalities, patient mortality early in the course of disease has been identified as a persistent phenomenon with variable reported rates and causes. Trends in early mortality over time have not been clearly defined. PATIENTS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database was used to identify adult patients with MM between 1975 and 2015. Association of available sociodemographic factors with all-cause and MM-specific early mortality (death within 6 months after the diagnosis of MM) was conducted by multivariate analysis. Trends in early mortality were studied by joinpoint regression analysis. RESULTS: Of the 90,975 MM cases included in this analysis, early mortality was noted in 21%. Median age was 68 years overall, and 75 years for the early mortality cohort (P < .01). The most common causes of death for early mortality were MM itself, followed by cardiovascular, infections, and renal failure. Male gender, "other" race/ethnicity group, advancing age, and West, Midwest or South regions (reference Northeast) were associated with increased risk of both all-cause and MM-specific early mortality. Joinpoint regression analysis of trends data resulted in 1 joinpoint for all-cause 6-month mortality (2006-2015), while 2 joinpoints were noticed for myeloma-specific 6-month mortality (1975-1987 and 2003-2015). CONCLUSION: Early mortality remains a significant unmet need for MM patient care, despite improving trends in recent years. Understanding the factors associated with early mortality can help develop individualized plans of patient care and mitigate circumstances that may contribute to early mortality among MM patients.
Authors: Mirian Brink; Kaz Groen; Pieter Sonneveld; Monique C Minnema; Annemiek Broijl; Avinash G Dinmohamed; Ellen van der Spek; Mark-David Levin; Paula F Ypma; Esther de Waal; Eduardus F M Ward Posthuma; Sonja Zweegman; Niels W C J van de Donk Journal: Blood Cancer J Date: 2021-11-11 Impact factor: 11.037