Predictive Factors of Early Mortality in Patients with Multiple Myeloma (MM). Multicentric Study in Chile (1998–2002).

There is no data about the prognosis of patients with MM in Chile, except mortality rate records. The objective of this study is to know the clinical features, survival rates and factors related to early mortality of cases with MM treated in six large medical centers in Chile.

Method: Retrospective demographic data, clinical features and survival rate records of patients with MM were collected between 1998 and 2002. Survival curves were generated and a multivariate analysis of factors associated to early mortality was carried out.

Results: Data of 245 patients was collected. A 51.8% of them corresponded to IgG myeloma, 25.3% to IgA and a 6.1% to light chains. Distribution according Durie and Salmon was: Stage I: 8.1%; Stage II: 12.7%; Stage III: 60.7% and 18.4% without information. It is pointed out that, among clinical features, a 50% of the cases presented anemia (Hb <10gr/dL), a 30% renal failure (creatininemia >2 mg/dL) and a 28% hypercalcemia (>10.5 mg/dL). The median survival was 33 months. A 20% of patients died within the six first months after diagnosis. The multivariate analysis identified three factors associated to early mortality (survival <6 months): males (p=0.016), beta2-microglobulin >3.5 mg/L (p=0.021) and albuminemia < 3.5 gr/dL (p=0.016).

Conclusions: It was observed that, in Chilean population, patients with MM presented a short survival time, and a significative proportion of patients (20%) died within the first six months after the first diagnosis. More than a half of cases were diagnosed at an advanced stage. (Durie and Salmon: Stage III). Three factors associated to early mortality, two of which (beta2-microglobulin and albuminemia) are the foundations of the new international staging system, might be identified.