Risk Factors for Early Mortality After AHCT in Multiple Myeloma

Researchers from the University of British Columbia and Vancouver General Hospital evaluated incidence and risk factors for mortality within one year of autologous hematopoietic cell transplantation (AHCT) for the treatment of multiple myeloma (MM).

For this study, which was published in Clinical Lymphoma, Myeloma, & Leukemia, the investigators retroactively reviewed rates of early mortality, defined as death within one year, among 962 patients who underwent AHCT between 2007 and 2019. The overall mortality rate was 4.3 (n=41). Patients who died were matched for age, sex, and year of transplant with surviving controls.

Most patients (97.6%) who had early mortality received at least one novel agent, and 80.5% of these patients received second-line chemotherapy. Upon multivariate analysis, comorbidities including anemia and hypercalcemia were associated with early mortality. High-risk cytogenetics and elevated lactate dehydrogenase also correlated with death within one year.

“Clinical parameters reflecting disease burden, as well as high-risk cytogenetics, are associated with early mortality post-AHCT,” wrote the authors in conclusion. “These patients have a dismal overall survival despite significant advances in treatment of patients with relapsed or refractory MM. Further study of these ultra-high-risk patients is required to improve disease management and may give further insights into the biology of relapse and resistance in MM.”