Early mortality in multiple myeloma: Experiences from a single institution

Yeh Ku Chen, Shao Min Han, Youngsen Yang, Tseng Hsi Lin, Huey En Tzeng, Kuang Hsi Chang, Wen Li Hwang, Chieh Lin Jerry Teng

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Multiple myeloma (MM) is a hematological malignancy that presents with infection, anemia, bone lesions, renal function impairment, and hypercalcemia. The survival of MM patients has improved in recent decades; however, early mortality remains a critical problem. The aim of this study was to identify the etiologies and clinical variables associated with early mortality in MM. In addition, the effects of bortezomib on reducing early mortality incidence were investigated. Method and materials: Medical records from 122 MM patients diagnosed between November 2007 and December 2013 were retrospectively reviewed. Early mortality was defined as death by any cause within the first 180 days after pathological diagnosis. Results: In newly diagnosed MM patients, early mortality occurred in 22.95% of patients. Infection accounted for 67.86% of early deaths. Multivariate analyses by Cox proportional-hazards regression showed that higher β2-microglobulin (P < 0.001) and serum lactate dehydrogenase (P < 0.001) levels, and lower serum albumin levels (P < 0.001) were associated with early mortality. Both first-line and greater than or equal to second-line bortezomib treatments were not associated with superior 180-day overall survival (P = 0.546 for first-line bortezomib treatment; P = 0.066 for greater than or equal to second-line bortezomib treatment). Conclusion: Our results suggest that infection is the leading cause of early death in MM. High β2-microglobulin, high serum lactate dehydrogenase, and low serum albumin levels are poor prognostic factors for early mortality. Bortezomib therapy does not appear to reduce the incidence of early mortality in MM patients.

Original languageEnglish
Pages (from-to)392-398
Number of pages7
JournalHematology
Volume21
Issue number7
DOIs
Publication statusPublished - Aug 8 2016
Externally publishedYes

Fingerprint

Multiple Myeloma
Mortality
L-Lactate Dehydrogenase
Serum Albumin
Cause of Death
Infection
Survival
Incidence
Hypercalcemia
Hematologic Neoplasms
Therapeutics
Serum
Medical Records
Anemia
Multivariate Analysis
Bortezomib
Kidney
Bone and Bones

Keywords

  • Bortezomib
  • Mortality
  • Multiple myeloma

ASJC Scopus subject areas

  • Hematology

Cite this

Chen, Y. K., Han, S. M., Yang, Y., Lin, T. H., Tzeng, H. E., Chang, K. H., ... Teng, C. L. J. (2016). Early mortality in multiple myeloma: Experiences from a single institution. Hematology, 21(7), 392-398. https://doi.org/10.1080/10245332.2015.1101969

Early mortality in multiple myeloma : Experiences from a single institution. / Chen, Yeh Ku; Han, Shao Min; Yang, Youngsen; Lin, Tseng Hsi; Tzeng, Huey En; Chang, Kuang Hsi; Hwang, Wen Li; Teng, Chieh Lin Jerry.

In: Hematology, Vol. 21, No. 7, 08.08.2016, p. 392-398.

Research output: Contribution to journalArticle

Chen, YK, Han, SM, Yang, Y, Lin, TH, Tzeng, HE, Chang, KH, Hwang, WL & Teng, CLJ 2016, 'Early mortality in multiple myeloma: Experiences from a single institution', Hematology, vol. 21, no. 7, pp. 392-398. https://doi.org/10.1080/10245332.2015.1101969
Chen, Yeh Ku ; Han, Shao Min ; Yang, Youngsen ; Lin, Tseng Hsi ; Tzeng, Huey En ; Chang, Kuang Hsi ; Hwang, Wen Li ; Teng, Chieh Lin Jerry. / Early mortality in multiple myeloma : Experiences from a single institution. In: Hematology. 2016 ; Vol. 21, No. 7. pp. 392-398.
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N2 - Objective: Multiple myeloma (MM) is a hematological malignancy that presents with infection, anemia, bone lesions, renal function impairment, and hypercalcemia. The survival of MM patients has improved in recent decades; however, early mortality remains a critical problem. The aim of this study was to identify the etiologies and clinical variables associated with early mortality in MM. In addition, the effects of bortezomib on reducing early mortality incidence were investigated. Method and materials: Medical records from 122 MM patients diagnosed between November 2007 and December 2013 were retrospectively reviewed. Early mortality was defined as death by any cause within the first 180 days after pathological diagnosis. Results: In newly diagnosed MM patients, early mortality occurred in 22.95% of patients. Infection accounted for 67.86% of early deaths. Multivariate analyses by Cox proportional-hazards regression showed that higher β2-microglobulin (P < 0.001) and serum lactate dehydrogenase (P < 0.001) levels, and lower serum albumin levels (P < 0.001) were associated with early mortality. Both first-line and greater than or equal to second-line bortezomib treatments were not associated with superior 180-day overall survival (P = 0.546 for first-line bortezomib treatment; P = 0.066 for greater than or equal to second-line bortezomib treatment). Conclusion: Our results suggest that infection is the leading cause of early death in MM. High β2-microglobulin, high serum lactate dehydrogenase, and low serum albumin levels are poor prognostic factors for early mortality. Bortezomib therapy does not appear to reduce the incidence of early mortality in MM patients.

AB - Objective: Multiple myeloma (MM) is a hematological malignancy that presents with infection, anemia, bone lesions, renal function impairment, and hypercalcemia. The survival of MM patients has improved in recent decades; however, early mortality remains a critical problem. The aim of this study was to identify the etiologies and clinical variables associated with early mortality in MM. In addition, the effects of bortezomib on reducing early mortality incidence were investigated. Method and materials: Medical records from 122 MM patients diagnosed between November 2007 and December 2013 were retrospectively reviewed. Early mortality was defined as death by any cause within the first 180 days after pathological diagnosis. Results: In newly diagnosed MM patients, early mortality occurred in 22.95% of patients. Infection accounted for 67.86% of early deaths. Multivariate analyses by Cox proportional-hazards regression showed that higher β2-microglobulin (P < 0.001) and serum lactate dehydrogenase (P < 0.001) levels, and lower serum albumin levels (P < 0.001) were associated with early mortality. Both first-line and greater than or equal to second-line bortezomib treatments were not associated with superior 180-day overall survival (P = 0.546 for first-line bortezomib treatment; P = 0.066 for greater than or equal to second-line bortezomib treatment). Conclusion: Our results suggest that infection is the leading cause of early death in MM. High β2-microglobulin, high serum lactate dehydrogenase, and low serum albumin levels are poor prognostic factors for early mortality. Bortezomib therapy does not appear to reduce the incidence of early mortality in MM patients.

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