Early mortality, kidney failure, and venous thromboembolism in patients with multiple myeloma: a single-center analysis

Introduction: The objectives were to assess early mortality, the prevalence of kidney failure, venous thromboembolism (VTE), and to assess overall survival (OS) in patients with multiple myeloma (MM). Material and methods: A retrospective analysis of clinical and laboratory parameters in 413 patients with MM treated between 2006 and 2017. Results: The early mortality rate in the study group was 13% (57 of the 413 patients). Mortality rates were higher in men [odds ratio (OR) = 1.4] ( p = 0.015), patients with kidney failure (OR = 9.1) ( p = 0.001), and patients with significant proteinuria and immunoglobulin A secretion (OR = 1.3). Early mortality was not associated with age, lactate dehydrogenase levels, or hemoglobin levels at diagnosis. Patients with kidney failure at diagnosis of MM had lower total protein levels ( p <0.001) and higher proteinuria levels ( p < 0.001) than the remaining patients. The 5-year OS in patients with kidney failure was 20% vs. 50% in those without kidney failure ( p <0.001). VTE was reported in 38 patients (10.7%). There was no association between VTE and the patient’s age, kidney failure, urinary protein levels, type of monoclonal protein, stage of MM according to the International Staging System, or type of induction therapy. The median OS in the study group was 4.08 years. There was no correlation between VTE and OS in patients undergoing autologous hematopoietic stem cell transplantation. Conclusions: The use of novel drugs with a different mechanism of action in the treatment of MM has led to an improvement in survival rates, with an increase in median OS from 3-4 years to 5-7 years over the past 10 years. Still, it is estimated that 25% of patients die within less than 2 years from diagnosis.