title: Beta-blockers improve survival outcomes in patients with multiple myeloma: a retrospective evaluation.
abstract: A preclinical study demonstrated anti-proliferative and apoptotic effect of propranolol on multiple myeloma (MM) cell. Clinical studies suggested that beta-blocker (BB) might impact the prognosis of breast, prostate, colorectal, ovarian, lung, and skin cancer. This retrospective study evaluated the effect of BB in MM disease-specific survival (DSS) and overall survival (OS). Among 1,971 newly diagnosed MM patients seen at Mayo Clinic between 1995 and 2010, usage of BB and other cardiac (or antihypertensive) medications were abstracted. Cumulative incidence function and Kaplan-Meier method were used to estimate 5-year cumulative incidence rate (CIR) of MM death and OS rate, respectively. Nine hundred and thirty (47.2%) patients had no intake of cardiac medications; 260 (13.2%) used BB alone; 343 (17.4%) used both BB/non-BB cardiac medications; and 438 (22.2%) had non-BB cardiac drugs. Superior MM DSS was observed in BB only users, compared to patients without any cardiac drugs ( HRadj.CS, 0.53, 95% confidence interval [CI], 0.42-0.67, Padj.<0.0001) and non-BB cardiac drugs users ( HRadj.CS, 0.49, 95% CI, 0.38-0.63, Padj.<0.0001). Patients on both BB and other cardiac drugs showed superior DSS than non-cardiac drugs users ( HRadj.CS, 0.54, 95% CI, 0.44-0.67, Padj.<0.0001) and non-BB cardiac drug users. ( HRadj.CS, 0.50, 95% CI, 0.40-0.62, Padj.<0.0001). MM DSS did not differ between BB users with and without other cardiac drugs (Padj.=0.90). Multivariable analysis showed the same pattern for OS. In patients with MM, BB intake is associated with a reduced risk of disease-specific death and overall mortality in comparison to non-BB or no use of cardiac drugs. Am. J. Hematol. 92:50-55, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Yi L
authors.initials: YL
authors.lastname: Hwa
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN.
authors.forename: Qian
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Shaji K
authors.initials: SK
authors.lastname: Kumar
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kapoor
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Francis K
authors.initials: FK
authors.lastname: Buadi
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.|Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Ronald S
authors.identifier: http://orcid.org/0000-0002-8284-3495
authors.initials: RS
authors.lastname: Go
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hayman
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Wilson I
authors.initials: WI
authors.lastname: Gonsalves
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Stephen
authors.initials: S
authors.lastname: Russell
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: John A
authors.initials: JA
authors.lastname: Lust
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018572:Disease-Free Survival; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality*; D012189:Retrospective Studies
chemical_list: D000319:Adrenergic beta-Antagonists; D000970:Antineoplastic Agents; D002317:Cardiovascular Agents