About 10% of patients with multiple myeloma will experience early mortality. Hsu et al identified risk factors for early death in these patients. The authors are from Taipei Veterans General Hospital, National Yang-Ming University and Taipei City Hospital in Taiwan.

Patient selection: recently diagnosed multiple myeloma


Risk factors for early mortality:

(1) male sex (OR 2.9)

(2) primary plasma cell leukemia (OR 17.6)

(3) low serum albumin (< 3.5 g/dL; OR 2.7)

(4) high serum calcium corrected for albumin levels (>= 12 mg/dL; OR 2.9)

(5) high serum LDH (>= 250 U/L; OR 3.1)



• The odds ratios for sex and serum chemistries are comparable. The odds ratio for plasma cell leukemia was 5-6 times greater.


Infection was the cause of death in two-thirds of the patients, so early and aggressive management of infections may improve survival.


Other causes of death:

(1) acute renal failure

(2) heart failure

(3) acute myocardial infarction

(4) bleeding

(5) hepatic failure

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