McQuilten et al reported predictors for early death in a patient with multiple myeloma. These can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Australia and New Zealand.
Patient selection: adult with multiple myeloma
Outcome: death from any cause within the first 12 months after the diagnosis
Predictors from multivariate analysis:
(1) older age (OR 1.07; use >= 70 years)
(2) ECOG performance status (OR 1.5; use 2-4)
(3) hypoalbuminemia (OR 0.95; use <= 30 g/L)
(4) cardiac disease (OR 1.96)
(5) International Staging System (OR 1.4; use ISS 3)
The risk of early mortality increases with the number of these present.
Additional factors from univariate analysis:
(1) cytogenetic abnormalities
(2) eGFR < 50 mL per min per 1.73 sq meters OR elevated serum creatinine
(3) pulmonary disease
(4) thrombocytopenia
(5) beta-2 microglobulin >= 6 mg/L
(6) worse overall health by EQ-5D
