Risk factors associated with mortality in patients with multiple myeloma

Introduction. According to foreign authors some laboratory markers and comorbidity are independent predictors of death in multiple myeloma (MM).

Aim. To identify risk factors associated with mortality in patients with MM.

Materials and methods. A retrospective analysis of 149 medical records of patients of the hematology department of the Regional Clinical Hospital with a diagnosis of multiple myeloma was carried out. The patients are divided into two groups depending on the clinical outcome: the 1^st  group includes 90 living patients; the 2^nd  group includes 59 patients whose death occurred in the hospital during the period from 2010–2019. Of the 149 patients: 87 women (58%), 62 men (42%). The mean age of the patients was 65.7 ± 8.7 years. The clinical, demographic and laboratory indicators of the groups were analyzed, and comorbidity was assessed using the Charlson index.

Results. In the 1^st  group of patients, there were 35 men (39%) and 55 women (61%). The ratio of men to women is 1:1.6. The mean age in this group is 67 ± 9.1 years. The 2^nd  group is represented by 27 (46%) men, 32 (54%) women. The mean age was 63.7 ± 7.6 years. In the 1^st  group of patients, all patients were diagnosed with stage III disease, with most patients in the subgroup associated with renal dysfunction (p = 0.002). Anaemia and markers of renal damage were more frequent in the group of deceased patients (p < 0.001, p = 0.002, respectively). Comparative analysis of laboratory indicators showed that in the haemogram of the group of living patients, the level of erythrocytes, haemoglobin, platelets was significantly higher than in group 2 (p < 0.05); the level of creatinine, urea was 1.8 times higher in the group of deceased patients than in the group of living patients (p < 0.05). Chronic heart failure was statistically significantly more common in the deceased group than in the living group (22% vs. 7.8%, p = 0.025). The incidence of pneumonia was higher in the deceased group than in the 1^st  group (p < 0.001).

Conclusion. Risk factors associated with mortality include manifestations of MM such as anaemia, thrombocytopenia, renal dysfunction and late diagnosis at stage III of the disease. Chronic heart failure, as a complication of cardiovascular disease, is a risk factor for adverse outcome. Comorbidity, infectious diseases (pneumonia) are associated with a worse prognosis, probably due to poorer tolerability of standard therapy.

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