医学
列线图
多发性骨髓瘤
多元分析
内科学
相伴的
养生
多元统计
阶段(地层学)
疾病
重症监护医学
预测模型
临床终点
接收机工作特性
回顾性队列研究
肿瘤科
总体生存率
生存分析
弗雷明翰风险评分
死亡率
临床试验
风险评估
外科
风险因素
结果(博弈论)
心力衰竭
作者
Xue Yang,Pu Wang,Tianhong Xu,Chenqi Yu,Yang Yang,Peng Liu
摘要
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.
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