Early mortality in multiple myeloma patients with renal impairment: a nested case-control study

Area of Science:

• Hematology
• Oncology
• Nephrology

Background:

• Renal impairment (RI) significantly affects outcomes in multiple myeloma (MM) patients.
• Early mortality within 12 months in newly diagnosed MM (NDMM) with RI is understudied in the novel agent era.

Purpose of the Study:

• To investigate the prevalence and risk factors for early mortality in NDMM patients with RI.
• To identify clinical indicators associated with early death in this specific patient population.

Main Methods:

• A nested case-control study of 199 NDMM patients with RI was conducted.
• 19 cases of early mortality were matched with 76 controls.
• Analysis included elevated N-terminal pro-brain natriuretic peptide (NT-proBNP), heart failure, lactate dehydrogenase (LDH), and pneumonia.

Main Results:

• The incidence of early death was 9.5%, with pneumonia being the leading cause.
• Elevated LDH levels and pneumonia at diagnosis were independent risk factors for early mortality.
• 1-year survival rates decreased significantly with an increasing number of risk factors (p < 0.001).

Conclusions:

• Elevated LDH levels and pneumonia at diagnosis are independent risk factors for early mortality in NDMM patients with RI.
• These findings aid in risk stratification and management of NDMM patients with renal impairment.