Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Blood Cancer J. 2021 Nov 11;11(11):178. doi: 10.1038/s41408-021-00571-8.
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.
识别多发性骨髓瘤（MM）患者早期死亡（EM）的风险因素可能有助于为有 EM 风险的患者提供不同的治疗方法。本基于人群的研究旨在评估荷兰 MM 患者 EM 的趋势和 EM 的风险因素。所有在荷兰癌症登记处新诊断为 MM 的患者，均于 1989 年至 2018 年期间确诊。患者分为三个日历时期（1989-1998、1999-2008、2009-2018）和五个年龄组（≤65、66-70、71-75、76-80、>80 岁）。EM 定义为诊断后≤180 天因任何原因导致的死亡。我们纳入了 28328 名 MM 患者（中位年龄 70 岁；55%为男性）。EM 从 1989-1998 年诊断的患者的 22%下降到 2009-2018 年诊断的患者的 13%（P<0.01），所有年龄组均观察到这种下降。无法阐明确切的死亡原因。除了患者的年龄，我们发现与疾病表现更具侵袭性相关的特征以及反映患者身体状况的患者特征与 EM 相关。总之，EM 从 1999 年开始下降。然而，EM 仍然很高，特别是对于年龄>70 岁的患者。因此，应该探索新的策略来改善有 EM 风险的患者的预后。
