Pb2126: retrospective real life study of multiple myeloma status at death.

Topic: 14. Myeloma and other monoclonal gammopathies - Clinical Background: Currently, we have numerous therapeutic options for relapses of multiple myeloma (MM). However, different studies shown an attrition rate of between 21-57% at each line of therapy (LOT), highlighting the use of the most optimal treatment early rather than reserving them for later. Considering that the median age of MM diagnosis is 70 years, we could assume that some MM patients will die due to causes unrelated to MM. Aims: The objective of our study is to analyze the situation of multiple myeloma at the time of patients’ death. Methods: We have included patients diagnosed with MM from 2011 to the present, at Hospital universitario de Alava and Complejo hospitalario de Navarra, who have died at the time of the study and had an available proteinogram in the 3 months prior to death. MM situation has been classified as myeloma in RC (MMrc); MM in progression (MMprog) and MM with active disease (MMad): not included in the above groups. The analysis was made in three groups: Fit: those candidates for TASPE, Intermediate (not candidates for TASPE but <75 years of age) and Elderly (≥75 years of age). In addition, for those patients who died in MMad, death has been classified as: infectious disease (ID), cardiovascular disease (CV), and others (Other). Results: 173 patients meet selection criteria. Overall, 10% of patients have died with MMrc, 39% of patients in MMprog and 51% of patients died in MMad. Considering the patients who died in withing the first 2 LOT, 63% were Elderly, 25% Intermediate, and 13% Fit, while those who died with ≥2 LOT, 38% were Elderly, 32% Intermediate, and 30% fit. Regarding the MM situation at the time of death for each group: Elderly: 11% died in MMrc, 57% in MMad and 32% in MMprog, for the intermediate: 5% in MMrc, 51% in MMad and 44 % in MMprog and for the fit group: 12% in MMrc, 31% in MMad and 58% in MMprogr. Considering cause of death for those in MMad, we observed for the elderly, intermediate and fit patients, 32%, 44% and 50% ID cause of death, respectively, additionally 13% and 10% of the elderly and intermediate patients died because of CV. Summary/Conclusion: In our series, 10% of the patients died in a CR situation, without differences among the three groups. However, 32% of patients ≥75 years died with the disease in progression compared to 58% of those candidates for TASPE. Moreover, up to 27% of the patients died because infection diseases with controlled MM. Not only efficacy, but also safety and tolerance should be taken into consideration for treatment selection, particularly for older MM patients.Keywords: Multiple myeloma, Myeloma