Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Sir Charles Gairdner Hospital, Perth, Australia.
Br J Haematol. 2022 Sep;198(5):830-837. doi: 10.1111/bjh.18324. Epub 2022 Jul 11.
The frequency and causes of early mortality in patients with newly diagnosed multiple myeloma (NDMM) have not been well described in the era of novel agents. We investigated early mortality in a prospective cohort study of all patients with NDMM registered on the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR) at 36 institutions between July 2011 and March 2020. Early mortality was defined as death from any cause within the first 12 months after diagnosis. A total of 2377 patients with NDMM were included in the analysis, with a median (interquartile range) age of 67.4 (58.9-74.60 years, and 60% were male. Overall, 216 (9.1%) patients died within 12 months, with 119 (4.5%) having died within 6 months. Variables that were independent predictors of early mortality after adjustment in multivariable regression included age (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.05-1.08; p < 0.001), Eastern Cooperative Oncology Group performance status (OR 1.50, 95% CI 1.26-1.79; p < 0.001), serum albumin (OR 0.95, 95% CI 0.93-0.98; p < 0.001), cardiac disease (OR 1.96, 95% CI 1.35-2.86; p < 0.001) and International Staging System (OR 1.40, 95% CI 1.07-1.82; p = 0.01). For those with a primary cause of death available, it was reported as disease-related in 151 (78%), infection 13 (7%), other 29 (15%). Infection was listed as a contributing factor for death in 38% of patients.
在新型药物治疗时代，新诊断多发性骨髓瘤（NDMM）患者的早期死亡率及其原因尚未得到充分描述。我们对 2011 年 7 月至 2020 年 3 月期间在澳大利亚和新西兰骨髓瘤及相关疾病登记处（MRDR）的 36 家机构登记的所有 NDMM 患者进行了前瞻性队列研究，以调查早期死亡率。早期死亡率定义为诊断后 12 个月内任何原因导致的死亡。共纳入 2377 例 NDMM 患者，中位（四分位间距）年龄为 67.4（58.9-74.60 岁），60%为男性。总体而言，216 例（9.1%）患者在 12 个月内死亡，其中 119 例（4.5%）在 6 个月内死亡。多变量回归分析中独立预测早期死亡的变量包括年龄（比值比 [OR] 1.07，95%置信区间 [CI] 1.05-1.08；p<0.001）、东部肿瘤协作组表现状态（OR 1.50，95%CI 1.26-1.79；p<0.001）、血清白蛋白（OR 0.95，95%CI 0.93-0.98；p<0.001）、心脏病（OR 1.96，95%CI 1.35-2.86；p<0.001）和国际分期系统（OR 1.40，95%CI 1.07-1.82；p=0.01）。对于那些有主要死因的患者，有 151 例（78%）的死因被报告为与疾病相关，13 例（7%）为感染，29 例（15%）为其他原因。38%的患者将感染列为死亡的促成因素。
