Progression of multiple myeloma is the leading cause of death in people with this type of blood cancer. However, newer treatments like immunotherapies have reduced myeloma-related deaths in recent years. As people live longer with myeloma, non-myeloma causes of death, such as heart disease and infections, are becoming more common.
In this article, we cover the most common causes of death in people with myeloma. We also discuss how mortality rates have changed over time and what factors play a role.
How Have Deaths in Multiple Myeloma Changed Over Time?
New myeloma treatments help people live longer, healthier lives with this type of cancer. Studies show that fewer people die from myeloma progression now compared to 20 years ago.
🗳️ Are you or your loved one living with any of these other health conditions along with multiple myeloma?
Heart disease
Kidney failure
Another form of cancer
More than one of these
Thanks! You've successfully submitted your vote.
One study showed that between 2008 and 2013, progression of the disease accounted for 86.4 percent of deaths. Between 2020 and 2025, progression accounted for 62.5 percent of deaths.
Although deaths from end-stage myeloma itself have decreased, they still account for the majority of deaths from multiple myeloma. Non-myeloma-related deaths rose from 7.6 percent in 2008 to 31.8 percent by 2025.
Myeloma progression is still the leading cause of death in people with the disease. But as people live longer with myeloma, other causes of death, such as heart disease and infections, are becoming more common.
Since people with myeloma are living longer than before, there’s more time to potentially develop complications, including some of the most common causes of death in the general population.
It Can Be Difficult To Find the Cause of Death With Multiple Myeloma
Finding the exact cause of death in someone with myeloma can be challenging.
For example, many people with myeloma have several complications at the same time. The combination of myeloma disease progression, treatment complications, and other underlying health conditions may all play a role in death from myeloma.
A study of 100 people with myeloma who died between 2016 to 2021 reported that at the time of death:
Multiple myeloma progression was responsible for 78 deaths
32 people also had complications from treatment, such as low blood cell counts
36 people also had infections (including four with COVID-19)
Since all of these factors can contribute to death from myeloma, doctors and researchers may have a hard time telling exactly what caused it.
Aging Raises the Risk of Complications
As we age, we’re more likely to develop other health problems. This is because our immune and other body systems don’t work as well as they used to.
Myeloma tends to affect older people. Half of people with the disease are diagnosed at or after age 70. This means they’re more likely to have myeloma along with other health conditions.
Older age with myeloma is also associated with worse outcomes. Studies show that older age and frailty affect mortality with myeloma. Frailty is a measure of how vulnerable a person is in older age.
For example, a frailer person with myeloma may also live with other health conditions along with memory and thinking problems.
A study of 4,617 people over age 65 with myeloma found the median overall survival after diagnosis was 34 months. This means that after 34 months, 50 percent of people in the study were still alive.
Severely frail people had a median overall survival of 17 months, while nonfrail people’s median overall survival was 65 months. These results show that age and general health play a large part in survival and death with myeloma.
What Conditions Cause Death in Multiple Myeloma?
Myeloma progression is still the leading cause of death with myeloma. But because recent advances in treatment have reduced cancer-related deaths, other causes are on the rise.
Cardiovascular Disease
Cardiovascular (heart and blood flow) diseases and myeloma both tend to affect older people. The combination of increased age and longer survival rates means heart disease is more common in people with myeloma. It’s worth noting that heart disease is the most common cause of death in the general population.
Heart disease is the most common cause of death in the general population and a common cause of death among people with multiple myeloma.
Studies show that people with myeloma are 1.84 times more likely to die from heart disease than the general population. Examples of heart disease seen in people with multiple myeloma include:
Diseases affecting how well the heart pumps blood
Hypertension (high blood pressure)
Atherosclerosis (fatty buildup in the arteries)
Cerebrovascular disease (problems affecting blood flow to the brain)
The mortality rate from cardiovascular disease is highest within the first year of getting diagnosed with myeloma. Researchers believe this is linked to myeloma treatments that damage the heart.
Race also plays a role in the risk of death from heart disease with myeloma. Black people with myeloma have higher death rates from heart disease than white people do.
Infections
Infections are another common cause of death in people with myeloma. A Swedish study of 8,672 people with myeloma found that 20 percent had died within one year after diagnosis. Infections were responsible for 27 percent of those deaths.
Many myeloma treatments work by suppressing the immune system. The result is that the body can’t fight off infections as well as it should.
For example, people treated with monoclonal antibodies, a type of immunotherapy, are more likely to develop lung infections like pneumonia. They’re also at higher risk of opportunistic infections — infections that affect people with weakened immune systems.
Treatment plans that combine prednisone and immunomodulatory imide drugs (IMiDs) can also raise the risk of deadly infections. These medications reduce the number of infection-fighting immune cells in the body.
Several bacterial and viral infections can lead to death with myeloma. The same Swedish study found that certain infections are more common with myeloma compared to the general population, including:
Blood infections
Bone infections
Kidney infections
Heart infections
Influenza (the flu)
Respiratory infections like pneumonia and respiratory syncytial virus (RSV) infection
Kidney Failure
Another cause of death in people with myeloma is kidney, or renal, failure. Your kidney health affects your overall health. These organs constantly filter your blood to remove waste products, toxins, and extra water.
Many people with myeloma have damaged kidneys. Myeloma cells make too many proteins that become stuck in the kidneys, affecting the filters inside. As damage worsens over time, the kidneys begin to fail.
Kidney disease-related deaths in people with myeloma are on the rise. Many people with myeloma have damaged kidneys.
One report of 786 people with myeloma found that 44 percent had a contributing cause of death in addition to worsening cancer. Of these people, 59 percent had kidney failure.
Other Types of Cancer
People with myeloma are at risk of developing other cancers. A study of more than 6,600 people with myeloma found that nonmyeloma cancers were the second leading cause of death.
The study found that other cancers that occurred in people with myeloma included:
- Lung cancer
- Colorectal cancer
- Acute myeloid leukemia (AML, another type of blood cancer)
Researchers are still learning more about why secondary cancers develop with myeloma. They know that some myeloma treatments damage blood-forming cells in the body, raising the risk of other blood cancers.
Studies show that having myeloma itself can also contribute to developing other cancers. Inflammation and dysfunctional immune cells are likely involved.
Talk to Your Doctor About Preventing Myeloma Complications
If you or a loved one are living with myeloma, it’s important to work closely with your cancer care team to prevent and manage complications. Be sure to get regular checkups and let your doctors know about any new or worsening symptoms.
Managing other health conditions along with myeloma will help you live as long as possible and feel your best.
Continue with Facebook
Continue with Email
Join
Your Privacy Choices
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.