Risk factors for early death in patients undergoing treatment for multiplemyeloma

The survival time of myeloma patients improved from a few months to many ye ars after treatment with melphalan. Perhaps chemotherapy more intensive tha n melphalan-prednisolone should be administered to patients at risk of earl y death. Therefore, early death must be accurately predicted. We analyzed 9 3 patients with recently diagnosed myeloma and found that 13 (14%) died wit hin 6 months (early death). The most common cause of death was bacterial an d fungal pneumonia when myeloma became uncontrollable. The response to conv entional chemotherapy was poorer in patients at high risk of early death th an the control group. Multivariate analysis showed that the serum level of beta-2 microglobulin was the only value that predicted early death.