摘要
Abstract
Objective:To characterize early multiple myeloma(MM)-specific mortality and competing-cause mortality after diagnosis in elderly patients with MM,and to evaluate differences in mortality risk across age groups.Methods:Using data from the Surveillance,Epi-demiology,and End Results(SEER)database,we included patients diagnosed with MM between 2000 and 2022 who were aged≥65 years at diagnosis.Patients were stratified into three age groups:65-74,75-84,and≥85 years.Cumulative incidence functions were used to esti-mate mortality at 3,6,and 12 months after diagnosis.Differences across age groups were assessed using Gray's test,and Fine-Gray models were applied to evaluate the association between age and MM-specific mortality.Results:A total of 55,049 eligible elderly patients with MM were included.At 3 months after diagnosis,the cumulative incidences of MM-specific death were 8.3%,15.1%,and 25.3%in patients aged 65-74,75-84,and≥85 years,respectively;corresponding estimates at 6 months were 11.3%,19.8%,and 32.6%,and at 12 months were 16.1%,26.2%,and 40.2%,demonstrating a clear age-related gradient.At 12 months,the cumulative incidences of other-cause death were 6.4%,9.3%,and 14.4%,respectively,all lower than the corresponding incidences of MM-specific death.Gray′s tests showed statistically sig-nificant differences across age groups for both MM-specific and other-cause mortality.In multivariable Fine-Gray analyses,compared with patients aged 65-74 years,the subdistribution hazard of MM-specific death was 36%higher in those aged 75-84 years(sHR=1.36,95%CI:1.32-1.39,P<0.001)and 79%higher in those aged≥85 years(sHR=1.79,95%CI:1.72-1.86,P<0.001).Sensitivity analyses after excluding patients with unknown racial information and those receiving chemotherapy yielded results consistent with the primary analysis.Conclusion:Elderly patients with MM experience a substantial risk of early MM-specific death after diagnosis,with a pronounced increase across advancing age groups.Advanced age is independently associated with a higher risk of MM-specific mortality,and the early mortality burden is particularly marked among patients aged≥85 years.Strengthening early risk assessment and age-adapted interventions may help reduce early mortality in elderly patients with MM.关键词
多发性骨髓瘤/老年患者/早期死亡/竞争风险/累积发生函数/Fine-Gray模型Key words
multiple myeloma/elderly patients/early mortality/competing risks/cumulative incidence function/Fine Gray model分类
医药卫生
