Trends in mortality from multiple myeloma in patients younger than 55 years of age in the United States: A retrospective analysis from 1999 to 2020

Abstract Background: Multiple myeloma is a malignancy of advanced age and is most commonly diagnosed in patients older than 65 years of age. Approximately 10 % of multiple myeloma cases occur in patients younger than 50 years of age. This disease cohort is somewhat underrepresented in the literature. The main purpose of study was to focus on the mortality trends in this rather significant but underrepresented disease cohort. Method: ICD-10 codes were used to identify deaths from multiple myeloma in the CDC WONDER database. The age-adjusted mortality rates (AAMR/100,000) for the population were extracted, and trends were analyzed for age, gender, race, and year. Result: There were a total of 16,706 deaths from multiple myeloma from 1999 to 2020 in patients younger than 55 years of age. Gender analysis of this cohort showed that both sexes have shown a gradual decrease in AAMR over the course of years. AAMR for females has decreased from 0.579 in 1999 to 0.380 in 2020. Similarly, the AAMR for males has decreased from 0.835 to 0.573. The mean AAMR for males was 0.69 per 100,000 population (range: 0.653–0.728; SD: 0.089), which was significantly higher than the rate observed in females (mean: 0.46; range: 0.430–0.490; SD: 0.072). Race analysis showed that Blacks or African Americans have significantly higher AAMR as compared to any other race. In fact, the mean AAMR for Black or African Americans was 1.293 (range: 1.197–1.388; SD: 0.215), which is 2.6 times higher as compared to Whites (mean: 0.494; range: 0.466–0.522; SD: 0.063), who have the second highest AAMR. Discussion: The trends in mortality from multiple myeloma in patients younger than 55 are similar to trends noted in older patients. There is a decreasing trend in mortality in both genders and all races among these patients. This trend is similar to the one noted in older age group patients. The highest rate of AAMR was noted in African Americans, which is similar to the trend noted in other epidemiological studies. Similarly, the finding that males have higher AAMR as compared to females also aligns with the findings in existing literature. The significantly higher mortality trends noted in the African American population highlight the need for targeted research to identify genetic, social, environmental and economic factors to guide further intervention strategies. The decrease in mortality trends can be attributed to advances in chemotherapy and immunotherapy.