Trends in cause of death among patients with multiple myeloma in Puerto Rico and the United States SEER population, 1987–2013

Abstract

Multiple myeloma (MM) survival has improved due to recent developments in MM treatment. As a result, other co‐morbid conditions may be of increasing importance to MM patients’ long‐term survival. This study examines trends in common causes of death among patients with MM in Puerto Rico, and in the US Surveillance, Epidemiology, and End Results (SEER) population. We analyzed the primary cause of death among incident MM cases recorded in the Puerto Rico Central Cancer Registry (n = 3,018) and the US SEER Program (n = 67,733) between 1987 and 2013. We calculated the cumulative incidence of death due to the eight most common causes and analyzed temporal trends in mortality rates using joinpoint regression. Analyses of SEER were also stratified by Hispanic ethnicity. MM accounted for approximately 72% of all reported deaths among persons diagnosed with MM in Puerto Rico and in SEER. In both populations, the proportion of patients who died from MM decreased with increasing time since diagnosis. Age‐standardized temporal trends showed a decreased MM‐specific mortality rate among US SEER (annual percent change [APC] = −5.0) and Puerto Rican (APC = −1.8) patients during the study period, and particularly after 2003 in non‐Hispanic SEER patients. Temporal decline in non‐MM causes of death was also observed among US SEER (APC = −2.1) and Puerto Rican (APC = −0.1) populations. MM‐specific mortality decreased, yet remained the predominant cause of death for individuals diagnosed with MM over a 26‐year period. The most pronounced decreases in MM‐specific death occurred after 2003, which suggests a possible influence of more recently developed MM therapies.

Causes of death in primary plasma cell leukemia differ from multiple myeloma: A STROBE-compliant descriptive study based on SEER database

“…A recent study showed that, myeloma caused 71.3% of deaths in SEER database and 71.7% in the database of the Puerto Rico Central Cancer Registry, among MM patients aged more than 40 between 1987 and 2013. [ 25 ] In our study, it was similar that 74.89% of deaths in MM patients were attributed to myeloma, but it was the second ranking cause of death in pPCL, which caused only 38.83% of deaths. Interestingly, 31.13% of pPCL patients who died of myeloma occurred in the first 6 months after diagnosis, however, the proportion was only 17.23% in MM.…”

Unusual biclonal IgA plasma cell myeloma with aberrant expression of high-risk immunophenotypes: first report of a new diagnostic and clinical challenge

“…The translational relevance of identifying these high-risk IgA PCM could be significant for PCM patients, especially in Puerto Rico. Although PCM survival has improved due to new treatment modalities, the majority (~72%) of Puerto Ricans diagnosed with PCM are still likely to die from PCM [ 18 ]. Also, for unknown reasons, the decline in PCM-specific mortality in Puerto Rico is less than in other comparable US populations [ 18 ].…”

Impact of academic medical center access on outcomes in multiple myeloma

“…Despite considerable advances in the treatment of multiple myeloma (MM) in recent decades, MM remains an incurable malignancy, associated with significant morbidity and mortality 1–4 . Therapeutic and supportive measures that reduce disease‐related complications and increase duration until disease progression are essential to improve the management of MM 2 .…”

“…Despite considerable advances in the treatment of multiple myeloma (MM) in recent decades, MM remains an incurable malignancy, associated with significant morbidity and mortality. [1][2][3][4] Therapeutic and supportive measures that reduce disease-related complications and increase duration until disease progression are essential to improve the management of MM. 2 Patients have greater access to such measures at the Commission on Cancer (CoC) accredited academic cancer centers (ACs), which are defined by the availability of MM specialists, access to comprehensive cancer treatment, and high patient volume, which has previously been shown to be independently associated with improved survival in MM.…”