Author:
Eisfeld Christine,Kajüter Hiltraud,Möller Lennart,Wellmann Ina,Shumilov Evgenii,Stang Andreas
Abstract
Abstract
Background
Steady evolution of therapies has improved prognosis of patients with multiple myeloma (MM) over the past two decades. Yet, knowledge about survival trends and causes of death in MM might play a crucial role in long-term management of this patient collective. Here, we investigate time trends in myeloma-specific survival at the population level over two decades and analyse causes of death in times of prolonged survival.
Methods
Age-standardised and age group-specific relative survival (RS) of MM patients aged < 80 years at diagnosis was estimated for consecutive time periods from 2000–2019 using data from the Cancer Registry of North Rhine-Westphalia in Germany. Conditional RS was estimated for patients who already survived one to five years post diagnosis. Causes of death in MM patients were analysed and compared to the general population using standardised mortality ratios (SMR).
Results
Three thousand three hundred thirty-six MM cases were included in the time trend analysis. Over two decades, age-standardised 5-year RS increased from 37 to 62%. Age-specific survival improved from 41% in period 2000–2004 to 69% in period 2015–2019 in the age group 15–69 years, and from 23 to 47% in the age group 70–79 years. Conditional 5-year RS of patients who survived five years after diagnosis slightly improved as compared to unconditional 5-year RS at diagnosis. MM patients are two times more likely to die from non-myeloma malignancies (SMR = 1.97, 95% CI 1.81–2.15) and from cardiovascular diseases (SMR = 2.01, 95% CI 1.86–2.18) than the general population.
Conclusions
Prognosis of patients with MM has markedly improved since the year 2000 due to therapeutic advances. Nevertheless, late mortality remains a major concern. As survival improves, second primary malignancies and cardiovascular events deserve increased attention.
Funder
Universitätsklinikum Münster
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
Reference41 articles.
1. Zentrum für Krebsregisterdaten im Robert Koch-Institut (RKI). Krebs in Deutschland für 2017/2018. RKI und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V., editors. 13th ed. Berlin: Publishername-Zentrum für Krebsregisterdaten im Robert Koch-Institut (RKI); 2021. p. 138–141.
2. Cowan AJ, Allen C, Barac A, Basaleem H, Bensenor I, Curado MP, et al. Global burden of multiple myeloma: a systematic analysis for the global burden of disease study 2016. Jama Oncol. 2018;4:1221–7.
3. Huang J, Chan SC, Lok V, Zhang L, Lucero-Prisno DE, Xu W, et al. The epidemiological landscape of multiple myeloma: a global cancer registry estimate of disease burden, risk factors, and temporal trends. Lancet Haematol. 2022;9(9):e670–7.
4. Piechotta V, Jakob T, Langer P, Monsef I, Scheid C, Estcourt LJ, et al. Multiple drug combinations of bortezomib, lenalidomide, and thalidomide for first‐line treatment in adults with transplant‐ineligible multiple myeloma: a network meta‐analysis. Cochrane Db Syst Rev. 2019;(11). https://doi.org/10.1002/14651858.CD013487, https://training.cochrane.org/resource/how-cite-cochrane-publications.
5. Costa LJ, Brill IK, Omel J, Godby K, Kumar SK, Brown EE. Recent trends in multiple myeloma incidence and survival by age, race, and ethnicity in the United States. Blood Adv. 2017;1:282–7.
Cited by
7 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献