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Myeloma

Prognostic variables for survival and skeletal complications in patients with multiple myeloma osteolytic bone disease

Leukemia volume 24, pages 1043–1049 (2010)Cite this article

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Abstract

Skeletal-related events (SREs) are common in patients with osteolytic lesions from multiple myeloma (MM), and result in substantial morbidity. We report herein a comprehensive, retrospective, multivariate analysis of prognostic factors for survival and first on-study SRE in MM patients using data from the phase III, randomized study comparing zoledronic acid with pamidronate in MM or breast cancer. Cox regression analyses were used to assess 22 variables for prognostic significance (defined as associations with P<0.05) in patients with bone metabolism marker assessments and complete baseline variable data. Of 510 evaluable MM patients, 282 had complete covariate information and were included in models. Reduced Cox multivariate models identified five significant prognostic factors for first SRE (weight, race, high N-terminal cross-linked telopeptide of type I collagen (NTX), high pain score, and need for narcotic analgesics) and seven for survival (age, SRE history, myeloma subtype, anemia, high lactate dehydrogenase, high NTX, and low albumin levels). High NTX was the only variable associated with elevated risks of both first SRE and death (P⩽0.02 for each). These analyses identified prognostic factors for SREs and survival in patients with MM. Taken together with current staging systems, these factors could further facilitate decision making for optimal treatment of myeloma bone disease, although further prospective assessments are needed.

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Article 15 October 2020

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Acknowledgements

Funding for medical editorial assistance was provided by Novartis Pharmaceuticals Corporation, East Hanover, New Jersey. We thank Dr Shalini Murthy for her medical editorial assistance with this paper.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece

    E Terpos

  2. Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA

    J Berenson

  3. Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada

    R J Cook

  4. Department of Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA, USA

    A Lipton

  5. Cancer Research Centre, University of Sheffield, Weston Park Hospital, Sheffield, UK

    R E Coleman

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Correspondence to E Terpos.

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Competing interests

Evangelos Terpos has received honoraria and research funding from Novartis and Janssen-Cilag. James Berenson has received honoraria and consulting fees from Novartis and has earlier given expert testimony on their behalf. Richard Cook has received honoraria and consulting fees from Abbott, Amgen, GlaxoSmithKline, and Novartis. Allan Lipton has participated as a consultant for Amgen, Novartis, Merck, Monogram, and GlaxoSmithKline; received honoraria from Amgen, Pfizer, and Novartis; and received research funding from Novartis, Monogram Biosciences, and Oncogene Sciences. Robert Coleman has received honoraria and consulting fees from Novartis and has earlier given expert testimony on their behalf.

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Terpos, E., Berenson, J., Cook, R. et al. Prognostic variables for survival and skeletal complications in patients with multiple myeloma osteolytic bone disease. Leukemia 24, 1043–1049 (2010). https://doi.org/10.1038/leu.2010.62

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