Abstract
To describe the prevalence of comorbidity and its impact on survival in newly diagnosed multiple myeloma patients compared with population controls. Cases of newly diagnosed symptomatic multiple myeloma during the 2005–2012 period were identified in the Danish National Multiple Myeloma Registry. For each myeloma patient, 10 members of the general population matched by age and sex were chosen from the national Civil Registration System. Data on comorbidity in the myeloma patients and the general population comparison cohort were collected by linkage to the Danish National Patient Registry (DNPR). Cox proportional hazards regression models were used to evaluate the prognostic significance of comorbidity. The study included 2190 cases of multiple myeloma and 21,900 population controls. The comorbidity was increased in multiple myeloma patients compared with population controls, odds ratio (OR) 1.4 (1.1–1.7). The registration of comorbidity was highly increased within the year preceding diagnosis of multiple myeloma (OR 3.0 [2.5–3.5]), which was attributable to an increased registration of various diseases, in particular, renal disease with OR 11.0 (8.1–14.9). The median follow‐up time from diagnosis of multiple myeloma for patients alive was 4.3 years (interquartile range 2.4–6.3). Patients with registered comorbidity had increased mortality compared with patients without comorbidity, hazard ratio 1.6 (1.5–1.8). Multiple myeloma patients have increased comorbidity compared with the background population, in particular during the year preceding the diagnosis of myeloma.
Highlights
The survival of multiple myeloma patients has improved over the last two decades with the introduction of new drugs [1, 2]
The overall comorbidity was increased in multiple myeloma patients compared with population controls, odds ratio (OR) 1.4 (1.1–1.7)
The prevalence of comorbidity was higher in patients over 65 years of age compared with the younger patients, for example, Table 1
Summary
The survival of multiple myeloma patients has improved over the last two decades with the introduction of new drugs [1, 2]. New treatment options have led to improved survival, multiple myeloma remains an incurable malignant disease and an important challenge is to apply data from clinical trials to the real-life population of multiple myeloma [4]. A frailty score was proposed by the International Myeloma Working Group including age, geriatric assessment, and comorbidity assessed by the Charlson Comorbidity Index [8]. This scoring system was based on data from three prospective clinical trials and predicts mortality and the risk of toxicity in myeloma patients. Data on the prevalence and impact of comorbidity in the real- life population of multiple myeloma patients is limited [5, 9]. We conducted a population-based Danish study of all patients with newly diagnosed multiple myeloma and a matched control population to compare the burden of comorbidity and to evaluate the impact of comorbidity on mortality
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