Coronary artery calcification score as a prognostic factor in younger patients with multiple myeloma undergoing autologous stem cell therapy.

Background: Coronary artery calcification (CAC) scoring can be performed as a by-product of computed tomography (CT). CAC scoring may reflect the general cardiovascular risk profile of patients. The aim of the present study was to determine the impact of CAC on overall survival (OS) in patients with multiple myeloma (MM).

Methods: A retrospective analysis was conducted on all patients with MM undergoing peripheral blood stem cell transplantation between the years 2009 and 2019. A total of 127 patients (50 female patients, 39.4%) with a mean age of 57.8 ± 7.6 years were included in the analysis. A whole-body CT scan was used to assess the CAC score for each patient. The Weston score as a surrogate for Agatston score was applied in the non-gated staging CT images.c RESULTS: A total of 27 patients (22.0%) died during the course of the study. The CAC score did not differ between non-survivors and survivors in the discrimination analysis (mean 1.2 ± 2.4 versus 2.0 ± 2.8, p = 0.13). The CAC score showed no correlation with overall survival, with an HR of 0.92 (95% CI 0.78-1.09, p = 0.35). Of the patients without calcification (CAC score 0, n = 66, 51.9%), 18 died, while of those with calcification (CAC score 1 or higher, n = 61, 48.1%), nine died. The results of the Fisher's exact test showed no statistically significant difference between the two groups (p = 0.20).

Conclusions: The presence of CT-defined coronary calcifications does not predict survival in younger patients with multiple myeloma undergoing autologous stem cell therapy and comparably short survival. The impact of CT-defined cardiovascular risk factors appears to be relatively modest in this heterogeneous disease.