Comorbidity as a prognostic variable in multiple myeloma: comparative evaluation of common comorbidity scores and use of a novel MM–comorbidity score
Open Access
- 16 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Blood Cancer Journal
- Vol. 1 (9), e35
- https://doi.org/10.1038/bcj.2011.34
Abstract
Comorbidities have been demonstrated to affect progression-free survival (PFS) and overall survival (OS), although their impact in multiple myeloma (MM) patients is as yet unsettled. We (1) assessed various comorbidities, (2) compared established comorbidity indices (CIs; Charlson comorbidity index (CCI), hematopoietic cell transplantation-specific comorbidity index (HCT-CI)), Kaplan Feinstein (KF) and Satariano index (SI) and (3) developed a MM-CI (Freiburger comorbidity index, FCI) in 127 MM patients. Univariate analysis determined moderate or severe pulmonary disease (hazard ratio (HR): 3.5, PP=0.0018), decreased Karnofsky Performance Status (KPS, HR: 2.7, P=0.0004) and age (HR: 2, P=0.0114) as most important variables for diminished OS. Through multivariate analysis, the eGFR ⩽30 ml/min/1.73m2, impaired lung function and KPS ⩽70% were significant for decreased OS, with HRs of 2.9, 2.8 and 2.2, respectively. Combination of these risk factors within the FCI identified significantly different median OS rates of 118, 53 and 25 months with 0, 1 and 2 or 3 risk factors, respectively, (P<0.005). In light of our study, comorbidities are critical prognostic determinants for diminished PFS and OS. Moreover, comorbidity scores are important treatment decision tools and will be valuable to implement into future analyses and clinical trials in MM.Keywords
This publication has 47 references indexed in Scilit:
- Renal Impairment in Patients With Multiple Myeloma: A Consensus Statement on Behalf of the International Myeloma Working GroupJournal of Clinical Oncology, 2010
- Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study GroupAnnals of Oncology, 2010
- Prognostic impact of age and gender in 897 untreated patients with primary myelodysplastic syndromesAnnals of Oncology, 2009
- Carbon Monoxide Diffusion Capacity: How Low Can You Go for Hematopoietic Cell Transplantation Eligibility?Transplantation and Cellular Therapy, 2009
- The changing prevalence of comorbidity across the age spectrumCritical Reviews in Oncology/Hematology, 2008
- Treatment of Newly Diagnosed Multiple Myeloma Based on Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART): Consensus StatementMayo Clinic Proceedings, 2007
- 160 years of multiple myeloma: Progress and challengesEuropean Journal of Cancer, 2006
- State of the art therapy in multiple myeloma and future perspectivesEuropean Journal of Cancer, 2006
- Comorbidities and Charlson score in resected stage I nonsmall cell lung cancerEuropean Respiratory Journal, 2005
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987