Predictors of Early Mortality in Patients with Multiple Myeloma in Urban Ugandan Cancer Treatment Centres: A Retrospective Study

Abstract

Background: Multiple myeloma (MM) is a clonal plasma cell proliferative disorder characterized by the abnormal increase of monoclonal paraprotein leading to evidence of specific end-organ damage.There is scanty literature on predictors of early mortality among multiple myeloma patients across sub-Saharan Africa and Uganda in particular.Therefore, this study assessed predictors of early mortality (six-months from MM diagnosis) among multiple myeloma patients in urban cancer centers of Uganda.Method: This was a retrospective chart review study among 191 participants, medical records reviewed were between December 2019 and February 2023.Data was collected using structured questionnaire, entered into REDCAP, transferred to STATA version 17.0 for statistical analysis.Descriptive statistics for continuous and categorical variables was done; chi-square test and logistic regression analysis were performed to determine predictors of early mortality among MM patients at confidence level of p<0.05. Results:In this study the mean age of participants was 57.66 years and SD 11.29years.Early mortality within six months of multiple myeloma diagnosis was 26.7% (51/191).Predictors of early mortality were; patient-reported fatigue (aOR: 2.38, CI: 1.01 -5.61, P=0.046), Hepatitis B infection (aOR: 11.83, CI: 1.49 -93.68,P=0.019), and Hemoglobin level <7.0g/dl (aOR: 3.45, CI: 1.39 -8.56, P=0.008), and non-adherence to treatment (aOR: 61.54, CI: 7.96 -675.5, P<0.001),were independently associated with early mortality among MM patients. Conclusion and Recommendation:Early mortality within six months of MM diagnosis is generally high MM among patients.The ministry of health and related stake holders in health should design strategies aimed at preventing early mortality among MM patients, these strategies may include but not limited to early screening for co-morbidities in MM patients, and optimize adherence to cancer treatment among patients.