Comorbidities in multiple myeloma and implications on survival: A population‐based study

Sverrisdottir, Ingigerdur Solveig; Rögnvaldsson, Sölvi; Þorsteinsdóttir, Sigrún; Gíslason, Gauti Kjartan; Aspelund, Thor; Turesson, Ingemar; Björkholm, Magnus; Gregersen, Henrik; Blimark, Cecilie; Landgren, Ola; Kristinsson, Sigurður Y.

doi:10.1111/ejh.13597

Cited by 24 publications

(15 citation statements)

References 46 publications

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“…Unlike these studies, the racial survival differences in MM were not statistically significant when matching on demographic variables. In sharp contrast, after adequately matching on presentation, NHBs had significantly longer survival than NHWs, suggesting the associations between increased number of comorbidities in NHBs and decreased survival [ 30 ]. The racial survival disparities were further enlarged after sequential matching on treatment which confirmed the effects of the observed treatment disparity on the survival disparity even among patients matched for presentation.…”

Section: Discussionmentioning

confidence: 99%

Black patients with multiple myeloma have better survival than white patients when treated equally: a matched cohort study

et al. 2022

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We assessed differences in survival between non-Hispanic black (NHB) and non-Hispanic white (NHW) patients with multiple myeloma (MM), and the sequential effects of patient characteristics, and diagnosis and treatment-related factors on the survival disparity using data from 3319 NHB and 20,831 NHW MM patients in the SEER-Medicare (1999–2017) database. Four sets of 3319 NHWs were matched sequentially to the same set of 3319 NHBs, based on demographics (age, sex, year of diagnosis, marital status, and SEER site), socioeconomic status (SES, demographics plus SES), presentation factors (SES variables plus comorbidity), and treatment factors (presentation variables plus antimyeloma therapies). We found NHBs were less likely to receive treatment than NHWs even among patients matched for demographics, SES, and comorbidities. The absolute difference in 5-year survival between NHBs and NHWs was not significant in the demographics match (0.6%; P = 0.30) and remained non-significant after matching for SES (1.4%, P = 0.17). When matching for presentation, NHBs had significantly longer 5-year survival than NHWs (absolute difference = 3.8%, P = 0.003). Additional matching on treatment-related factors further enlarged the racial difference in 5-year survival to 4.6% (P < 0.001). Our findings reinforce the importance of equitable access to effective treatment modalities to further improve the survival of NHB patients with MM.

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Section: Discussionmentioning

confidence: 99%

Black patients with multiple myeloma have better survival than white patients when treated equally: a matched cohort study

et al. 2022

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“…Our study also showed that patients with MM who had arrhythmias had a higher Charlson Comorbidity Index. A study in Sweden found higher comorbidities in patients with MM with an associated increased risk of death in those with arrhythmias 34. On further analyses of comorbidities associated with inpatient mortality among patients with MM with arrhythmias, acute MI, CVD, renal disease, and metastatic cancer were found to predict higher inpatient mortality.…”

Section: Discussionmentioning

confidence: 95%

Burden of arrhythmias and predictors of mortality among multiple myeloma patients with arrhythmias

Balogun

Jackson

Oyenuga

et al. 2022

Journal of Investigative Medicine

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Arrhythmias are a major cardiac complication reported among patients with multiple myeloma (MM), but these have not been further characterized in this population. We explored the prevalence of arrhythmias and examined the predictors of mortality among patients with MM with arrhythmias. The National Inpatient Sample data collected between 2016 and 2018 were used to conduct retrospective analyses. Multivariable logistic regression analyses were done to examine the predictors of mortality among patients with MM with arrhythmias. 16.9% of patients with MM reported a diagnosis of any arrhythmias and 70.7% of these were atrial fibrillation. Patients aged 70 years and above had 21% lower odds (adjusted OR (AOR): 0.79; 95% CI: 0.68 to 0.92) of inpatient mortality relative to younger patients. Those in the non-Hispanic black, Hispanic, and non-Hispanic other category were 1.38 (95% CI: 1.16 to 1.64), 1.53 (95% CI: 1.19 to 1.97), and 1.69 (95% CI: 1.29 to 2.21) times more likely to die during hospitalization compared with their counterparts who were non-Hispanic whites. Relative to patients with MM who were on Medicare, those on private (AOR: 1.28; 95% CI: 1.06 to 1.54) and other insurance types (AOR: 1.78; 95% CI: 1.23 to 2.58) had higher odds of mortality. Other predictors of inpatient mortality were elective admission (AOR: 0.67; 95% CI: 0.52 to 0.85) and Charlson comorbidity indices between 5–7 (AOR: 1.23; 95% CI: 1.07 to 1.41) and ≥8 (AOR: 1.45; 95% CI: 1.21 to 1.73) compared with comorbidity indices between 0 and 4. Our study adds to the body of knowledge on the need for proper diagnosis and management of cardiac arrhythmias in patients with MM. Research is needed to further assess the time of arrhythmia diagnosis and its impact on health outcomes among patients with MM.

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“…While mortality in MM declined in all other age groups, it modestly increased in those aged 80 + years. A recent Swedish study showed that over half of MM patients have comorbidities and these correlated with age and survival disadvantage 24 . Thus competing fatal causes are likely to be most prevalent among the old.…”

Section: Discussionmentioning

confidence: 99%

Incidence, mortality and survival in multiple myeloma compared to other hematopoietic neoplasms in Sweden up to year 2016

Hemminki

Försti

Hansson

2021

Sci Rep

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Survival in multiple myeloma (MM) has developed favorably over the past decades for reasons that have been ascribed to new medications and treatment. However, development of survival over a long period and comparison to other hematopoietic neoplasms (HN) is less well known. Here we used Swedish cancer data from the Nordcan database, spanning a 50-year period from 1967 to 2016, and analyzed 1- and 5-year survival data. As a novel type of analysis we calculate the difference in survival between year 1 and 5 which indicates how well survival was maintained in the 4-year period following year 1 after diagnosis. The relative 1- and 5- year survival increased constantly; the 5-year survival graph for women was almost linear. The difference between 1- and 5-year survival revealed that the 5-year survival gain was entirely due to the improvement in 1-year survival, except for the last period. Survival improvement in all HNs exceeded that in MM. The linear 5-year survival increase for female MM patients suggests a contribution by many small improvements in the first year care rather than single major events. The future challenges are to push the gains past year 1 and to extend them to old patients.

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Comorbidities in multiple myeloma and implications on survival: A population‐based study

Cited by 24 publications

References 46 publications

Black patients with multiple myeloma have better survival than white patients when treated equally: a matched cohort study

Black patients with multiple myeloma have better survival than white patients when treated equally: a matched cohort study

Burden of arrhythmias and predictors of mortality among multiple myeloma patients with arrhythmias

Incidence, mortality and survival in multiple myeloma compared to other hematopoietic neoplasms in Sweden up to year 2016

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