What is a comorbidity? Which are most prevalent in newly diagnosed myeloma?

What is a comorbidity?

Comorbidity is a chronic disease that is not myeloma that you have besides your myeloma. You can say that it could be chronic, pulmonary lung disease. It can be congestive heart failure or diabetes.And other cancers as well.

What comorbidities are most prevalent in newly diagnosed myeloma? 

I can tell you a little bit about what it is in Denmark, because I think that comorbidities varies from culture to culture. But what we do have and we did a study again on the Danish quality database, And what was interesting was that, one year preceding the diagnosis, there was an increase in comorbidities. And there is, comorbidities like kidney failure, which is part of the, myeloma disease, but also congestive heart failure, chronic pulmonary lung diseases, diabetes was there. And in total, 40%of the patients had, comorbidities at diagnosis.So that's a lot of, a lot of patients with comorbiditiesas early, in their myeloma history,because it also develops throughout, their history due to treatment.

How do comorbidities impact treatment decisions?

You will have worse outcome. And we present to that the hazard ratio was about two, I think in in overall survival, which is quite a lot. You do modify treatment because you don't choose a drug that will give you neuropathy. If you have neuropathy, and if you, for example, also have have had a previous pulmonary embolism, then you are reluctant with the IMiDs, it can be done. But you have to be very careful. And I think that today where you have so many treatment options, I mean, it's it's the patients do better patients that have comorbidities, for example, chronic pulmonary diseases and heart diseases that are severe. They cannot go to a transplant. A transplant is still the first option for younger patients in Scandinavia. I know it's changing in U.S., but it's still what we do here. And then you have to treat them otherwise. And with the standard treatments that available for first and modifying the treatment. If you are, so unlucky that you have comorbidity that will disqualify you from the best treatment. I think that even in countries where there are restrictions to treatment, then you should really work very hard for giving the absolute best treatment you can for the patients, even though it may not be approved the diagnosis simply because, the life expectancy of this patient could be shorter. And we know that you should use the best thing you can at diagnosis if you want a long life.