Original Article

Pre-existing diabetes mellitus in patients with multiple myeloma

  1. Yi-Sheng Chou1,2,†,
  2. Ching-Fen Yang2,3,†,
  3. Harn-Shen Chen2,4,
  4. Sheng-Hsiang Yang1,2,
  5. Yuan-Bin Yu1,2,
  6. Ying-Chung Hong1,2,
  7. Chun-Yu Liu1,2,
  8. Jyh-Pyng Gau1,2,
  9. Jin-Hwang Liu1,2,
  10. Po-Min Chen1,2,
  11. Tzeon-Jye Chiou2,5,
  12. Cheng-Hwai Tzeng1,2,
  13. Liang-Tsai Hsiao1,2,6,*

Article first published online: 21 JUL 2012

DOI: 10.1111/j.1600-0609.2012.01828.x

Issue

European Journal of Haematology

European Journal of Haematology

Volume 89, Issue 4, pages 320–327, October 2012

Additional Information

How to Cite

Chou, Y.-S., Yang, C.-F., Chen, H.-S., Yang, S.-H., Yu, Y.-B., Hong, Y.-C., Liu, C.-Y., Gau, J.-P., Liu, J.-H., Chen, P.-M., Chiou, T.-J., Tzeng, C.-H. and Hsiao, L.-T. (2012), Pre-existing diabetes mellitus in patients with multiple myeloma. European Journal of Haematology, 89: 320–327. doi: 10.1111/j.1600-0609.2012.01828.x

Author Information

  1. 1

    Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  2. 2

    National Yang-Ming University School of Medicine, Taipei, Taiwan

  3. 3

    Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  4. 4

    Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  5. 5

    Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  6. 6

    Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan

  1. †

    Both authors contributed equally.

* Correspondence Dr. Liang-Tsai Hsiao, Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 112, Taiwan. Tel: +886 2 28712121 ext 2507; Fax: +886 2 28757762; e-mail: lthsiao@vghtpe.gov.tw

  1. †

    Both authors contributed equally.

Publication History

  1. Issue published online: 13 SEP 2012
  2. Article first published online: 21 JUL 2012
  3. Accepted manuscript online: 3 JUL 2012 08:18AM EST
  4. Manuscript Accepted: 26 JUN 2012

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Keywords:

  • type 2 diabetes mellitus;
  • hyperglycaemia;
  • hypoglycaemia;
  • multiple myeloma;
  • all-cause mortality

Abstract

Objectives

Type 2 diabetes mellitus is present in approximately 10% of patients at diagnosis of multiple myeloma (MM) and is associated with increased risks of adverse events caused by novel antimyeloma agents. However, the impact of type 2 diabetes on the survival of patients with MM has not been studied.

Methods

We enrolled newly diagnosed patients with MM in Taipei Veterans General Hospital between 1999 and 2007 and identified those with pre-existing diabetes. The impact of pre-existing diabetes on patients with MM was evaluated by comparing clinical features, treatments and adverse reactions related to glycaemic control and overall survival (OS) of patients with and without pre-existing diabetes.

Results

Of 310 patients with MM, 73% were men and 40 (12.9%) had pre-existing diabetes. Compared with their non-diabetic counterparts, MM patients with pre-existing diabetes had a significantly higher proportion of renal impairment [(RI), serum creatinine ≥2.0 mg/dL] and International Staging System stage III at diagnosis, and a significantly lower proportion of bisphosphonate use and a lower rate of RI reversal (P = 0.087). During the course of the disease, hyperglycaemia and hypoglycaemia of any grade were noted in 23 (67.6%) and 6 (17.6%) of these patients, respectively. Antidiabetic therapy was changed in 10 (29.4%) of 34 evaluable patients. MM patients with pre-existing diabetes had a significantly higher all-cause mortality risk (hazard ratio, 1.509; 95% confidence interval, 1.023–2.225, P = 0.037) compared with their non-diabetic counterparts.

Conclusions

Our study demonstrated the impact of pre-existing diabetes on clinical features and OS in patients with MM.

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