Real-World Data Analysis on Early Mortality in Chinese Multiple Myeloma Patients: Analysis of 1093 Patients During a 15-Year Period.

Despite the survival benefit observed in recent decades, early mortality (EM) remains critical in newly diagnosed multiple myeloma (NDMM) patients, with heterogeneous definitions and risk factors across studies. Besides, prognostic models for predicting EM are limited, especially in real-world scenarios. This single-center retrospective study performed comprehensive analyses as well as risk prediction models of 1093 NDMM patients diagnosed between 2007 and 2021 in China, finding the EM rate was 5.9% at 2 months, 8.8% at 6 months and 13.3% at 12 months. Infection and cardiac events were documented as the top two most common causes of early death. Risk factors that were independent predictors of both EM and OS mainly included cardiac amyloidosis, stroke, del (17p) and poor performance status. ISS stage, platelet count, treatment regimen and concomitant cardiac disease influenced OS rather than EM. Multivariate model-based nomograms were constructed to estimate 2-month, 6-month, 12-month mortality, plus OS, enabling individualized outcome prediction, validated via receiver operating characteristic (ROC) and calibration curves. EM is associated with multiple factors in MM patients, and early identification of patients with higher risk of EM may translate into tailored management in clinical practice.