Identification of risk factors for early mortality (EM) in multiple myeloma (MM) patients may contribute to different therapeutic approaches in patients at risk for EM. This population-based study aimed to assess trends in EM and risk factors for EM among MM patients diagnosed in the Netherlands. All MM patients, newly diagnosed between 1989 and 2018, were identified in the Netherlands Cancer Registry. Patients were categorized into three calendar periods (1989–1998, 1999–2008, 2009–2018) and into five age groups (≤65, 66–70, 71–75, 76–80, >80 years). EM was defined as death by any cause ≤180 days post-diagnosis. We included 28,328 MM patients (median age 70 years; 55% males). EM decreased from 22% for patients diagnosed in 1989–1998 to 13% for patients diagnosed in 2009–2018 (P < 0.01) and this decrease was observed among all age groups. Exact causes of death could not be elucidated. Besides patient’s age, we found that features related to a more aggressive disease presentation, and patient characteristics reflecting patients’ physical condition were predictive of EM. In summary, EM decreased from 1999 onwards. Nevertheless, EM remains high, especially for patients aged >70 years. Therefore, novel strategies should be explored to improve the outcome of patients at risk for EM.

识别多发性骨髓瘤 (MM) 患者早期死亡 (EM) 的风险因素可能有助于在有 EM 风险的患者中采用不同的治疗方法。这项基于人群的研究旨在评估荷兰诊断出的 MM 患者的 EM 趋势和 EM 风险因素。荷兰癌症登记处确定了 1989 年至 2018 年间新诊断的所有 MM 患者。患者分为三个日历期（1989-1998、1999-2008、2009-2018）和五个年龄组（≤65、66-70、71-75、76-80、>80 岁）。EM被定义为诊断后≤180天的任何原因死亡。我们纳入了 28,328 名 MM 患者（中位年龄 70 岁；55% 为男性）。EM 从 1989-1998 年诊断的患者的 22% 下降到 2009-2018 年诊断的患者的 13%（P < 0.01），并且在所有年龄组中都观察到了这种下降。确切的死亡原因无法阐明。除了患者的年龄，我们发现与更具侵袭性的疾病表现相关的特征以及反映患者身体状况的患者特征可以预测 EM。总之，新兴市场从 1999 年开始下降。尽管如此，EM 仍然很高，尤其是对于年龄 >70 岁的患者。因此，应探索新的策略来改善有 EM 风险的患者的预后。