A retrospective analysis of factors impacting survival in United States military Veterans with multiple myeloma

Abstract: This study investigates the long-term outcomes and causes of death in multiple myeloma (MM) patients treated in the Veterans Health Administration (VHA), with a focus on the effects of Agent Orange (AO) exposure. Using a cohort of 13,127 veterans diagnosed with MM between 2001 and 2020, patient characteristics, including age, race, tobacco use, and AO exposure, were analyzed. Overall survival (OS) and disease-specific survival (DSS) were calculated, with Kaplan-Meier curves estimating survival rates. Key findings revealed that AO-exposed veterans had longer median OS (5.3 years) compared to unexposed veterans (3.5 years). Black veterans also demonstrated longer survival than White veterans. Treatments such as immunomodulatory drugs (IMiDs) and CD38 monoclonal antibodies were associated with improved survival, while tobacco use and certain chemotherapy agents, including cyclophosphamide and doxorubicin, were linked to shorter survival. This study provides valuable insights into survival outcomes in veterans with MM and highlights the impact of AO exposure and race on survival.

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