Early mortality following the diagnosis of multiple myeloma from 2011 to 2016 in Alberta, Canada: Initial results from the population-based Identifying Outcomes in Real-World Multiple Myeloma (INFORMM) study
In addition to the treatment landscape results presented at the 24th Congress of the European Hematology Association (EHA), the results on early mortality in patients with multiple myeloma (MM) in Alberta were recently published online as an e-abstract from the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, IL (May 31 – June 4).
Among patients with newly diagnosed MM (NDMM), early mortality can be influenced by patient age, comorbidities, performance status, therapy and disease biology. Previous estimates from the literature indicate that early mortality following MM diagnosis remains a concern, with one study reporting 13% incidence of mortality at 2 months to another study reporting 29% incidence of mortality at one year following diagnosis. In the INFORMM Study, we investigated the incidence of early mortality within 90 days of diagnosis among patients with NDMM in Alberta, Canada in the era of novel agents (2011-2016).
The study cohort consisted of 1,729 patients with NDMM, of which 185 patients (20.7%) experienced early mortality. Of these 185 patients, most were aged ≥65 years (n=156, 84.3%), and had a Charlson Comorbidity Index score of ≥ 3 (n=174, 94.1%). In addition, n=48 patients (25.9%) had infectious complications within 90 days of diagnosis (pneumonia, sepsis, bacteremia, meningitis or cellulitis). Of the 185 early mortality cases, n=99 (53.5%) received myeloma treatment, while n=86 (46.5%) did not receive treatment.
While clinical outcomes in patients with NDMM have been improving with novel agents and therapies such as autologous stem cell transplantation, early mortality in MM remains a concern for consideration for clinicians, particularly in patients who are older with increased comorbidities.