Risk factors and causes for early mortality in patients with newly diagnosed multiple myeloma in a "real world" study: experiences of the Polish Myeloma Group.

INTRODUCTION Despite the progress made in multiple myeloma (MM) treatment, approximately 10-15% of patients die within the first year of diagnosis. OBJECTIVES To determine early mortality (EM) risk factors in patients with newly diagnosed (ND) MM treated with new drugs in clinical practice. PATIENTS AND METHODS 197 patients with symptomatic MM, diagnosed between October 2006 and November 2019, with survival < 12 months, were included in the multicentre analysis. RESULTS Median overall survival (OS) was 2.5 months. The most common causes of EM were infections (35%), MM progression (23.8%), and cardiovascular disease (14.2%). In a multivariable analysis, the Zubrod performance score (ZPS, P = 0.02), history of cardiovascular disease (P = 0.04), dependence on renal dialysis (P = 0.03), and MM response (P < 0.001) were associated with EM. CONCLUSIONS Early mortality in MM patients requires further studies. When qualifying patients with NDMM for chemotherapy, it is necessary to consider PS and the history of comorbidities, including cardiovascular diseases.