Perspectives in multiple myeloma: survival, prognostic factors and disease complications in a single centre between 1975 and 1988.
One hundred and forty-one patients with multiple myeloma, diagnosed at the City Hospital, Nottingham between January 1975 and October 1986, were followed until death or for at least two years in a retrospective study. Overall median survival was 25 months, with no significant improvement occurring during the study period; increasing age, ESR and serum creatinine concentration at diagnosis were independent predictors of shortened survival. Renal impairment developed in 56 per cent of patients but only 7 per cent died of renal failure. At least one episode of infection occurred in 55 per cent of patients, most commonly in the first month. There was a significant rise in the overall incidence of infection and in the proportion caused by Gram-negative bacteria during the study period. Raised serum urea and low haemoglobin concentrations at diagnosis were independent risk factors for subsequent infection. Infection was associated with 2.75-fold increased risk of death, independent of other risk factors. Prevention of infection is an important aim for improvements in the survival of patients in multiple myeloma.
Rayner
H C
HC
Department of Medicine, City Hospital, Nottingham.
Haynes
A P
AP
Thompson
J R
JR
Russell
N
N
Fletcher
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000150:complications; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate