PMID- 33658169
OWN - NLM
STAT- MEDLINE
DCOM- 20220121
LR  - 20220121
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 21
IP  - 6
DP  - 2021 Jun
TI  - Clinical Outcomes Associated With Chronic Kidney Disease in Elderly Medicare 
      Patients With Multiple Myeloma.
PG  - 401-412.e24
LID - S2152-2650(21)00033-1 [pii]
LID - 10.1016/j.clml.2021.01.015 [doi]
AB  - BACKGROUND: Chronic kidney disease (CKD) is common in patients with multiple 
      myeloma (MM) and is associated with a poor prognosis. We assessed CKD-associated 
      clinical outcomes among elderly patients with MM initiating chemotherapy in the 
      United States. MATERIALS AND METHODS: We identified elderly Medicare 
      beneficiaries (>/=66 years) diagnosed with MM who initiated first-line therapy from 
      2008 to 2014. We identified CKD using diagnosis codes. We followed patients for 
      death, time to next treatment (TTNT), and myeloma-defining events (anemia, 
      hypercalcemia, skeletal-related events, progression to/of CKD) until September 
      30, 2015. We estimated overall survival, TTNT, and cumulative incidence of 
      myeloma-defining events using the Kaplan-Meier method and risk of CKD-associated 
      outcomes using Cox proportional hazards models, adjusting for demographics and 
      comorbid conditions. RESULTS: Of 22,484 included patients, 8704 (39%) had CKD at 
      first-line therapy initiation. Compared with patients without CKD, patients with 
      CKD had shorter median overall survival (2.1 vs. 3.6 years) and median TTNT (10.0 
      vs. 12.4, 9.7 vs. 11.2, 8.3 vs. 9.2, and 6.9 vs. 8.3 months at first- to 
      fourth-line therapy). Probability of CKD progression for patients at stages 1 to 
      5 was higher than the probability of developing CKD for patients without CKD 
      (3-year cumulative incidence [95% confidence interval, CI], 47% [45-48%] vs. 27% 
      [24-26%]). Adjusted hazard ratios for CKD versus non-CKD were: all-cause death, 
      1.23 (95% CI, 1.18-1.28); anemia, 1.34 (95% CI, 1.24-1.45); hypercalcemia, 1.23 
      (95% CI, 1.09-1.38); skeletal-related events, 0.85 (95% CI, 0.90-0.91); and TTNT, 
      from 1.03 (95% CI, 0.96-1.10) at third-line therapy to 1.15 (95% CI, 1.04-1.27) 
      at fourth-line therapy. CONCLUSION: Data from the study suggest that 
      CKD-associated clinical burden is substantial in elderly patients with MM.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Li, Shuling
AU  - Li S
AD  - Chronic Disease Research Group, Minneapolis, Minneapolis Medical Research 
      Foundation, Minneapolis, MN. Electronic address: Shuling.Li@cdrg.org.
FAU - Gong, Tingting
AU  - Gong T
AD  - Chronic Disease Research Group, Minneapolis, Minneapolis Medical Research 
      Foundation, Minneapolis, MN.
FAU - Kou, Chuanyu
AU  - Kou C
AD  - Chronic Disease Research Group, Minneapolis, Minneapolis Medical Research 
      Foundation, Minneapolis, MN.
FAU - Fu, Alan
AU  - Fu A
AD  - Center for Observational Research, Amgen Inc, Thousand Oaks, CA.
FAU - Bolanos, Rachel
AU  - Bolanos R
AD  - Center for Observational Research, Amgen Inc, Thousand Oaks, CA.
FAU - Liu, Jiannong
AU  - Liu J
AD  - Chronic Disease Research Group, Minneapolis, Minneapolis Medical Research 
      Foundation, Minneapolis, MN.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210130
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cause of Death
MH  - Disease Management
MH  - *Geriatric Assessment/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - *Medicare
MH  - Mortality
MH  - Multiple Myeloma/*complications/*epidemiology/therapy
MH  - Patient Outcome Assessment
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Public Health Surveillance
MH  - Renal Insufficiency, Chronic/*complications/*epidemiology
MH  - Retrospective Studies
MH  - United States/epidemiology
OTO - NOTNLM
OT  - Anemia
OT  - CKD Progression
OT  - Hyperkalemia
OT  - Skeletal-related events
OT  - Survival
EDAT- 2021/03/05 06:00
MHDA- 2022/01/22 06:00
CRDT- 2021/03/04 05:38
PHST- 2020/08/26 00:00 [received]
PHST- 2021/01/15 00:00 [revised]
PHST- 2021/01/21 00:00 [accepted]
PHST- 2021/03/05 06:00 [pubmed]
PHST- 2022/01/22 06:00 [medline]
PHST- 2021/03/04 05:38 [entrez]
AID - S2152-2650(21)00033-1 [pii]
AID - 10.1016/j.clml.2021.01.015 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2021 Jun;21(6):401-412.e24. doi: 
      10.1016/j.clml.2021.01.015. Epub 2021 Jan 30.