Fractures and Survival in Multiple Myeloma: Results from a Population-Based Study

Multiple myeloma (MM) patients with a fracture at diagnosis have a higher risk of dying compared to patients without a fracture, according to a study presented at the 17th International Myeloma Workshop.

In this study, researchers assessed patients diagnosed with MM from the Swedish Cancer Register, collating information on date of birth, MM diagnosis, fractures, and death from central registries. They used a Cox regression model to estimate the impact of fractures at diagnosis within 30 days before or after diagnosis. The researchers used a second Cox regression model to evaluate fractures as time-dependent variables. Subsequently, they compared the difference in the link between fracture and survival in two calendar periods – 1990 to 1999 and 2000 to 2013. Overall, 14,013 patients were diagnosed with MM during the study, of which nearly 9% were diagnosed with a fracture at MM diagnosis, and 23% were diagnosed with a fracture following MM diagnosis.

After adjusting for age, sex, time of diagnosis, and previous fractures, the results showed that patients with a fracture at diagnosis were at a significantly higher risk of death (HR=1.28; 95% CI, 1.19 to 1.37). Moreover, the risk of death was notably increased for patients who developed a fracture after the time of MM diagnosis (HR=2.00; 95% CI, 1.90 to 2.10), for all fractures combined.

“Our large study, including over 14,000 patients diagnosed with MM in Sweden in the years 1990 to 2013, shows that patients with a fracture at diagnosis have a 28% higher risk of dying compared to patients without a fracture,” the researchers wrote in their conclusion.

They added that MM patients who “develop a fracture after the time of MM diagnosis are at twofold risk of dying compared to MM patients that do not develop a fracture, and this risk has not decreased significantly after the introduction of more effective treatment agents in MM. Our results stress the importance of preventing bone disease in MM.”

Ledergor Thorsteinsdottir, et al. Fractures and Survival in Multiple Myeloma: Results from a Population-Based Study. Presented at the 17th International Myeloma Workshop; September 12-15, 2019; Boston, MA.