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Decrease in early mortality for newly diagnosed multiple myeloma patients in the Netherlands: a population-based
Mirian Brink1, Kaz Groen2, Pieter Sonneveld3
1Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. m.brink@iknl.nl.
Abstract:
Identification of risk factors for early mortality (EM) in multiple myeloma (MM) patients may contribute to different therapeutic approaches in patients at risk for EM. This population-based study aimed to assess trends in EM and risk factors for EM among MM patients diagnosed in the Netherlands. All MM patients, newly diagnosed between 1989 and 2018, were identified in the Netherlands Cancer Registry. Patients were categorized into three calendar periods (1989-1998, 1999-2008, 2009-2018) and into five age groups (≤65, 66-70, 71-75, 76-80, >80 years). EM was defined as death by any cause ≤180 days post-diagnosis. We included 28,328 MM patients (median age 70 years; 55% males). EM decreased from 22% for patients diagnosed in 1989-1998 to 13% for patients diagnosed in 2009-2018 (P < 0.01) and this decrease was observed among all age groups. Exact causes of death could not be elucidated. Besides patient's age, we found that features related to a more aggressive disease presentation, and patient characteristics reflecting patients' physical condition were predictive of EM. In summary, EM decreased from 1999 onwards. Nevertheless, EM remains high, especially for patients aged >70 years. Therefore, novel strategies should be explored to improve the outcome of patients at risk for EM.
Insights
Early mortality in multiple myeloma (MM) decreased significantly from 1989-2018. However, it remains high for older patients, necessitating new strategies to improve outcomes for those at risk.
Area of Science:
- Hematology
- Oncology
- Epidemiology
Background:
- Early mortality (EM) in multiple myeloma (MM) poses a significant challenge.
- Identifying risk factors for EM is crucial for developing targeted therapeutic strategies.
- Understanding trends in EM can inform clinical practice and patient management.
Purpose of the Study:
- To assess temporal trends in early mortality (EM) among multiple myeloma (MM) patients.
- To identify risk factors associated with early mortality in MM.
- To evaluate changes in EM over three decades in the Netherlands.
Main Methods:
- Population-based study using the Netherlands Cancer Registry.
- Inclusion of 28,328 MM patients diagnosed between 1989 and 2018.
- Categorization by calendar periods (1989-1998, 1999-2008, 2009-2018) and age groups.
Main Results:
- EM decreased from 22% (1989-1998) to 13% (2009-2018) (P < 0.01).
- This reduction in EM was observed across all age groups.
- Patient age, aggressive disease presentation, and poorer physical condition predicted EM.
Conclusions:
- Early mortality in multiple myeloma has decreased since 1999.
- EM remains a concern, particularly for patients over 70 years old.
- Novel strategies are needed to improve outcomes for MM patients at risk of early mortality.
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