Terebelo et al identified risk factors for early mortality in a patient with multiple myeloma. These can help to identify a patient who may require more aggressive management or who may benefit from an alternative therapy. The authors are from Providence Cancer Center, Celgene Corporation, Maryland Oncology Hematology, Indiana University, Duke University, Steeplechase Cancer Center, University of South Carolina, Rocky Mountain Cancer Centers and the University of Texas MD Anderson Cancer Center.
Patient selection: multiple myeloma
Outcome: early mortality (within 180 days of diagnosis, alternatively <= 6 months)
Analysis: multivariate analysis
Risk Factors
Odds Ratio
LN(Odds Ratio)
age
1.7
0.530628
ECOG
3.89
1.358409
hypertension
1.96
0.672944
ISS disease stage
1.85
0.615185
serum creatinine
1.59
0.463734
platelet count
2.29
0.828551
mobility
2.42
0.883768
where:
• ISS is the International Staging System based on beta-2 microglobulin and serum albumin.
These risk factors are combined in a matrix in Figure 1 with 192 combinations.
The matrix can be approximated by the following logistic regression equation (not provided in the article).
Parameter
Finding
Points
age in year
<= 75 years
0
> 75 years
0.530628
ECOG score
0 or 1
0
2 to 4
1.358409
hypertension
absent
0
present
0.672944
ISS disease stage
I or II
0
III
0.615185
serum creatinine
<= 2 mg/dL
0
> 2 mg/dL
0.463734
platelet count
> 150,000 per µL
0
<= 150,000 per µL
0.828551
mobility
no problem walking around
0
some problems
0.883768
confined to bed
2 * 0.883768
X =
= SUM(points for all 7 paramters) - 4.59512
probability of early mortality =
= 1 / (1 + EXP((-1) * X)
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