文章：

荷兰新诊断多发性骨髓瘤患者早期死亡率下降：一项基于人群的研究

Decrease in early mortality for newly diagnosed multiple myeloma patients in the Netherlands: a population-based study

原文发布日期：2021-11-11

DOI: 10.1038/s41408-021-00571-8

类型: Article

开放获取: 是

英文摘要：

Identification of risk factors for early mortality (EM) in multiple myeloma (MM) patients may contribute to different therapeutic approaches in patients at risk for EM. This population-based study aimed to assess trends in EM and risk factors for EM among MM patients diagnosed in the Netherlands. All MM patients, newly diagnosed between 1989 and 2018, were identified in the Netherlands Cancer Registry. Patients were categorized into three calendar periods (1989–1998, 1999–2008, 2009–2018) and into five age groups (≤65, 66–70, 71–75, 76–80, >80 years). EM was defined as death by any cause ≤180 days post-diagnosis. We included 28,328 MM patients (median age 70 years; 55% males). EM decreased from 22% for patients diagnosed in 1989–1998 to 13% for patients diagnosed in 2009–2018 (P < 0.01) and this decrease was observed among all age groups. Exact causes of death could not be elucidated. Besides patient’s age, we found that features related to a more aggressive disease presentation, and patient characteristics reflecting patients’ physical condition were predictive of EM. In summary, EM decreased from 1999 onwards. Nevertheless, EM remains high, especially for patients aged >70 years. Therefore, novel strategies should be explored to improve the outcome of patients at risk for EM.
 

摘要翻译： 

识别多发性骨髓瘤患者早期死亡风险因素可能有助于为存在早期死亡风险的患者制定差异化治疗方案。这项基于人群的研究旨在评估荷兰诊断的多发性骨髓瘤患者中早期死亡的趋势及相关风险因素。我们通过荷兰癌症登记处确定了1989年至2018年间新确诊的所有多发性骨髓瘤患者。将患者按诊断年份分为三个时期（1989-1998年、1999-2008年、2009-2018年）和五个年龄组（≤65岁、66-70岁、71-75岁、76-80岁、>80岁）。早期死亡定义为诊断后180日内任何原因导致的死亡。研究共纳入28,328例患者（中位年龄70岁；55%为男性）。早期死亡率从1989-1998年诊断患者的22%下降至2009-2018年诊断患者的13%（P<0.01），该下降趋势在所有年龄组中均得以观察到。具体死因尚未明确。除患者年龄外，研究发现与疾病侵袭性表现相关的特征以及反映患者体能状况的特征均可预测早期死亡。总之，自1999年以来早期死亡率持续下降，但尤其对于70岁以上患者而言，该数值仍处于较高水平。因此，需探索新的治疗策略以改善存在早期死亡风险患者的预后。

原文链接：

Decrease in early mortality for newly diagnosed multiple myeloma patients in the Netherlands: a population-based study