To evaluate the prognostic value of early disease progression and early mortality in multiple myeloma patients and their integration with patient-related factors.
Key Findings:
POD18 occurred in 44.0% and POD24 in 51.2% of patients during a median follow-up of 60 months.
POD18 was associated with inferior OS (HR 9.38; 95% CI 5.98–14.70; p < 0.0001) and showed superior prognostic discrimination compared to POD24 (C-index 0.742 vs. 0.719).
Early mortality occurred in 17.9% of patients and was independently associated with advanced disease stage.
The prognostic impact of baseline staging decreased over time, indicating the dynamic nature of risk in multiple myeloma.
Interpretation:
POD18 is a robust dynamic prognostic marker that outperforms POD24 in predicting survival in real-world multiple myeloma patients.
Limitations:
The study is retrospective and may be subject to selection bias.
Findings may not be generalizable to all multiple myeloma populations.
Conclusion:
Integration of early disease kinetics with baseline disease burden and comorbidity burden provides a pragmatic framework for dynamic risk stratification.
