Comorbidity characteristics of multiple myeloma patients diagnosed in Finland 2005–2016

Abstract

Multiple myeloma (MM) patients are predominantly elderly with comorbidities that have an impact on patient mortality and treatment decisions. We previously reported the patient characteristics and overall survival outcomes of the Finnish MM cohort diagnosed between 2005 and 2016 in a nationwide retrospective registry study comprising 3,851 adults. Here, we report detailed comorbidity characteristics for this real-world Finnish MM population at cohort entry and during follow-up. Data on diagnoses and causes of death were obtained from Finnish healthcare data registries and interrogated using various multistate time-to-event models. In the year preceding MM diagnosis, comorbidities (as per Charlson Comorbidity Index definition) were recorded in 38.0% of the cohort, of which 27.9% presented with pre-existing cardiovascular disease (CVD) and 4.8% had suffered a major adverse cardiac event (MACE). At 2 years post-MM diagnosis, cumulative incidence for CVD and MACE more than doubled to 57.1% and 11.4%, respectively, and only 31.9% of the cohort remained CVD-free. Prevalent secondary malignancies were recorded in 16.8% of the patient population at MM diagnosis, with cumulative incidence increasing steadily to 27.5% at 2 years and 33% at 5 years post-diagnosis. The main cause of mortality attributed to MM, CVD, secondary malignancy, or other causes remained stable throughout the follow-up, at an average of 74.2%, 9.4%, 9.8%, and 6.5%, respectively. Prevalence of CVDs and secondary malignancies is high in Finnish patients at MM diagnosis, with older male patients suffering from higher MACE and mortality risk. Proper recording and management of comorbidities alongside novel treatments remain crucial for optimal MM management.

Real‐world experience of novel multiple myeloma treatments in a large, single‐center cohort in Finland

“…Deeper responses were achieved in earlier lines of therapy, further emphasizing the importance of optimizing treatment sequencing [27,39]. It is noteworthy that a recent Finnish cohort study reported that the comorbidity burden in the Finnish MM population is high, especially the prevalence of cardiovascular diseases and secondary malignancies, in line with previous observations [40][41][42][43]. This further highlights the fact that there are profound differences between the real-world patient populations and those run under strictly controlled clinical trial protocols.…”

Safety and Effectiveness of Elotuzumab in Japanese Patients with Relapsed/Refractory Multiple Myeloma: A Post-marketing Surveillance Study

“…Cardiovascular comorbidities are common in patients with MM and occur due to patient-, disease-, or treatment-related factors (20). As most MM drugs can have adverse effects, especially on the cardiovascular system, these comorbidities can pose a challenge when assessing the optimal treatment course and outcomes in patients with MM (21). Therefore, it is crucial to record and manage comorbidities alongside MM treatment for the optimal management of MM.…”

Real-world treatment outcomes of carfilzomib plus dexamethasone in patients with relapsed and/or refractory multiple myeloma, focusing on the impact of trial-fitness: Catholic Research Network for Multiple Myeloma Study (CARE-MM 2203)

“…When patients with RRMM receive anti-myeloma therapy after failure of early lines of therapy, they may present with a worse clinical status and comorbidities than at the time of diagnosis (Song et al 2016;Toppila et al 2022), which may be due to the disease progression itself or the cumulative effect of therapy-related toxicity. Previous reports have showed that these debilitating features are associated with poor outcomes in RRMM patients.…”