Early mortality in multiple myeloma: Experiences from a single institution

Area of Science:

• Hematology
• Oncology

Background:

• Multiple myeloma (MM) is a hematological malignancy characterized by infection, anemia, bone lesions, renal impairment, and hypercalcemia.
• While patient survival has improved, early mortality remains a significant challenge in MM management.

Purpose of the Study:

• To identify the causes and clinical factors associated with early mortality in multiple myeloma.
• To investigate the impact of bortezomib treatment on reducing early mortality in MM patients.

Main Methods:

• Retrospective review of medical records from 122 newly diagnosed MM patients (November 2007 - December 2013).
• Early mortality defined as death within 180 days of pathological diagnosis.
• Cox proportional-hazards regression analysis used for multivariate assessment.

Main Results:

• Early mortality occurred in 22.95% of newly diagnosed MM patients.
• Infections were responsible for 67.86% of early deaths.
• Elevated beta-2 microglobulin and lactate dehydrogenase, and decreased serum albumin levels were significantly associated with early mortality (P < 0.001).
• Bortezomib treatment (first-line or later) did not significantly improve 180-day overall survival.

Conclusions:

• Infection is the leading cause of early death in MM.
• High beta-2 microglobulin, high lactate dehydrogenase, and low serum albumin are poor prognostic indicators for early mortality in MM.
• Bortezomib therapy did not demonstrate a reduction in early mortality incidence in this MM patient cohort.