Background: advances in treatment has improved greatly survival of multiple myeloma in the last two decades, and this improvement has been endorsed by wider use of novel drugs and tandem autologous stem cell transplantation. however, still there were cases died earlier post diagnosis Objectives: to study the risk factors of early mortality in patients with multiple myeloma in Kurdistan region of Iraq Patients and methods: a 176 cases that were diagnosed with symptomatic multiple myeloma between (January 2012 -July 2019) in cancer centers in Kurdistan region of Iraq. a total of 152 were continued within the study through their recorded sheet. their data were analysed to determine what are the main risk factors that have an impact on early mortality among our myeloma patients. Results: among the total of 152 studied patients nine of them (5.9%) died early. the highest proportion (32.2%) of the sample aged 60-69 years, more than half (57.2%) of the them were male. the majority of the patients (80.9%) have been diagnosed during 2016-2019. the incidence of early death was 8.7% among patients who didn't take the cytotoxic treatment compared with 1.7% of patients who took that treatment, but the difference was not significant (P = 0.089). the early death rate was significantly high (22.2%) among patients who didn't take the immunomodulatory drugs, versus 2.4% of patients who took the immunomodulatory drugs (P = 0.001). the incidence of early mortality was 9.6% among patients with lactate dehydrogenase of ≥ 250 U/L compared with 0% among patients with LDH of less than 250 (P = 0.013). Conclusion:LDH level is a high prediction in finding early mortality among patients with multiple myeloma, and intake of immunomodulatory drugs is highly preventive in early death occurrence.

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