Early mortality in multiple myeloma: the time-dependent impact of comorbidity: A population-based study in 621 real-life patients
| Autor: | Jose Manuel Puerta, Juan Sainz, Rafael Ríos-Tamayo, Pilar Garrido, Antonio Romero, Juan José Lahuerta, Pedro Antonio González, Joaquin Martinez-Lopez, José Luís García de Veas, Lucía Moratalla, Teresa Rodríguez, Manuel Jurado, José Juan Jiménez-Moleón, Elisa López-Fernández, Daysi-Yoe-Ling Chang, María José Sánchez |
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| Rok vydání: | 2016 |
| Předmět: |
Pediatrics
medicine.medical_specialty education.field_of_study business.industry Population Hematology Disease medicine.disease Comorbidity 03 medical and health sciences Liver disease 0302 clinical medicine 030220 oncology & carcinogenesis Cohort Medicine Young adult business education Survival rate Multiple myeloma 030215 immunology |
| Zdroj: | American Journal of Hematology. 91:700-704 |
| ISSN: | 0361-8609 |
| Popis: | Multiple myeloma is a heterogeneous disease with variable survival; this variability cannot be fully explained by the current systems of risk stratification. Early mortality remains a serious obstacle to further improve the trend toward increased survival demonstrated in recent years. However, the definition of early mortality is not standardized yet. Importantly, no study has focused on the impact of comorbidity on early mortality in multiple myeloma to date. Therefore, we analyzed the role of baseline comorbidity in a large population-based cohort of 621 real-life myeloma patients over a 31-year period. To evaluate early mortality, a sequential multivariate regression model at 2, 6, and 12 months from diagnosis was performed. It was demonstrated that comorbidity had an independent impact on early mortality, which is differential and time-dependent. Besides renal failure, respiratory disease at 2 months, liver disease at 6 months, and hepatitis virus C infection at 12 months, were, respectively, associated with early mortality, adjusting for other well-established prognostic factors. On the other hand, the long-term monitoring in our study points out a modest downward trend in early mortality over time. This is the first single institution population-based study aiming to assess the impact of comorbidity on early mortality in multiple myeloma. It is suggested that early mortality should be analyzed at three key time points (2, 6, and 12 months), in order to allow comparisons between studies. Comorbidity plays a critical role in the outcome of myeloma patients in terms of early mortality. Am. J. Hematol. 91:700-704, 2016. © 2016 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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