The Library
Early mortality after diagnosis of multiple myeloma: Analysis of patients entered onto the United Kingdom Medical Research Council trials between 1980 and 2002 - Medical Research Council Adult Leukaemia Working Party
Tools
Tools
Tools
Augustson, B. M., Begum, G., Dunn, Janet A., Barth, N. J., Davies, F., Morgan, G., Behrens, J., Smith, A., Child, J. A. and Drayson, M. T. (2005) Early mortality after diagnosis of multiple myeloma: Analysis of patients entered onto the United Kingdom Medical Research Council trials between 1980 and 2002 - Medical Research Council Adult Leukaemia Working Party. Journal of Clinical Oncology, 23 (36). pp. 9219-9226. doi:10.1200/JCO.2005.03.2086
Research output not available from this repository, contact author.
Official URL: https://doi.org/10.1200/JCO.2005.03.2086
Abstract
Purpose: Early mortality in multiple myeloma (MM) is usually attributed to combined effects of active disease and comorbid factors. We have studied early deaths in a series of large multicenter trials to assess direct causes of death, their predictability, and whether current management strategies have reduced their frequency. Patients and Methods: A total of 3,107 newly diagnosed patients entered onto United Kingdom Medical Research Council MM trials from 1980 to 2002 were studied. Trial files, final clinical summaries, and postmortem reports were analyzed. Results: Death within 60 days of trial entry occurred in 299 patients (10%). Logistic regression modeling identified beta 2-microglobulin, performance status, and age as the most important predictors of early death, but only with 61% sensitivity and 73% specificity. Forty-five percent of deaths were attributable to infection, which was often associated with bone pain (particularly thoracic pain) and delay in presenting to medical care. Neutropenia was present at diagnosis in only 11 of the 135 deaths from infection. Renal failure was present in 28% of early deaths and was linked to light-chain MM, hypercalcemia, dehydration, and nonsteroidal anti-inflammatory drugs. There was no time related reduction in the percentage or nature of early deaths in 1,550 patients older than 65 years receiving similar therapy between 1982 and 2002. Conclusion: A tenth of patients die within 60 days of diagnosis of MM. Infection and renal failure are the main direct causes of early mortality, which cannot be accurately predicted by presenting prognostic features. All patients should be considered at high risk of death during induction therapy. © 2005 by American Society of Clinical Oncology.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
||||||
| Journal or Publication Title: | Journal of Clinical Oncology | ||||||
| Publisher: | American Society of Clinical Oncology | ||||||
| ISSN: | 0732-183X | ||||||
| Official Date: | 20 December 2005 | ||||||
| Dates: |
|
||||||
| Volume: | 23 | ||||||
| Number: | 36 | ||||||
| Page Range: | pp. 9219-9226 | ||||||
| DOI: | 10.1200/JCO.2005.03.2086 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
