1. © ANZDATA Registry CANCER CHAPTER CHAPTER 10

2. © ANZDATA Registry CharacteristicMyelomaNon-Myeloma n%n% Total (%)807153,37199 Country of residence Australia6908644,25683 New Zealand117159,11517 Primary renal disease Myeloma6367900 Potentially Myeloma related4766081 Glomerulonephritis/IgA nephropathy35415,90630 Diabetes24312,72824 Other65824,12945 Age at ESKD <551241524,78446 55-642252811,86222 65-742983710,99321 75+160205,73211 Sex Female3003722,48242 Male5076330,88958 Era of ESKD <1990801012,95624 1990-19947096,49112 1995-199997129,05117 2000-20042563211,21121 2005-20093042613,66226 First Dialysis modality Haemodialysis6688336,53968 Peritoneal dialysis1391716,83232 Racial background Non-white47611,79222 White7609441,57978 Other malignancy prior to ESKD None7439249,68293 Pre-dialysis malignancy6483,6897 Other malignancy subsequent to ESKD None7869748,76691 Post-dialysis malignancy2134,6059 Smoking history at ESKD Never or unknown3444331,66759 Current or former4635721,70441 Diabetes Mellitus No5897336,82869 Yes131168,18815 Unknown *87118,35516 Status during follow-up Alive1171521,14940 Died6908632,222 60 Table 1: Characteristics of people with and without myeloma treated by dialysis between 1963-2009

3. © ANZDATA Registry Figure 1: Plot of myeloma diagnosis relative to timing of ESKD and dialysis commencement

4. © ANZDATA Registry Figure 2a: Unadjusted survival on dialysis for myeloma versus non myeloma patients

5. © ANZDATA Registry Figure 2b Unadjusted survival on dialysis, stratified by primary renal disease

6. © ANZDATA Registry Era of dialysis MyelomaNon-myeloma NMedian (IQR)NMedian age (IQR) <19908061.5 (55.2 - 66.1)12,95647.0 (33.7 - 57) 1990-19947064.6 (56.7 - 70.1)6,49155.4 (41.4 - 65.2) 1995-19999765.8 (57.9 - 72.2)9,05158.6 (45.2 - 68.7) 2000-200425668.4 (59.4 - 74.9)11,21161.4 (48.6 - 71.7) 2005-200930468.9 (61.7 - 74.6)13,662 62.5 (50.4 - 72.9) Table 2: Average age of people starting dialysis through time

7. © ANZDATA Registry Cause of death Myeloma Total deaths 609 Non myeloma Total deaths 32, 223 N (%) Cardiovascular102 (14.8)12, 842 (39.9) Vascular23 (3.3)3, 478 (10.8) Infection70 (10.1)4, 785 (14.9) Cancer383 (55.5)2, 739 (8.5) Social99 (14.4)5, 934 (18.4) Other13 (1.9) 2, 445 (7.6) Table 3: Cause of death for people on dialysis with and without myeloma in Australia and New Zealand 1963-2009 *

8. © ANZDATA Registry Figure 3: Unadjusted survival on dialysis for people with (MM) and without myeloma (non- MM), by age at starting dialysis and stratified by era of treatment *

9. © ANZDATA Registry Univariate Multivariate CharacteristicHazard ratio (95% CI) P for difference Hazard ratio (95% CI) P for difference Primary renal disease Myeloma (referent)1.00.00021.00.0004 Potentially Myeloma related0.7 (0.5-0.9) 0.6 (0.5-0.9) Glomerulonephritis/IgA nephropathy 0.7 (0.5-1.0) 0.7 (0.5-1.1) Diabetes0.7 (0.5-1.1) 0.7 (0.5-0.8) Other0.6 (0.5-0.8) 0.6 (0.4-0.8) Age <55(referent)1.0<0.00011.0<0.0001 55-640.8 (0.7-1.1) 0.9 (0.7-1.2) 65-741.4 (1.1-1.7) 1.6 (1.3-2.1) 75+1.3 (1.0-1.7) 1.7 (1.3-2.3) Sex Female (referent)1.00.73 Male1.0 (0.9-1.2) Era of dialysis <1990 (referent)1.00.51 1990-19941.1 (0.8-1.5) 1995-19990.8 (0.6-1.1) 2000-20041.0 (0.8-1.3) 2005-20091.0 (0.7-1.2) Timing of myeloma diagnosis relative to ESKD > 5 years before ESKD (referent)1.00.15 1-5 years before ESKD1.1 (0.8-1.4) 1-11 months before ESKD1.3 (1.0-1.7) Peri ESKD (within 1 month before or after ESKD) 1.3 (1.0-1.7) 1-12 months after ESKD1.1 (0.8-1.6) First Dialysis modality Haemodialysis (referent)1.00.061.00.006 Peritoneal dialysis0.8 (0.7-1.0) 0.7 (0.6-0.9) Racial background Non-white (referent)1.00.59 White0.9 (0.7-1.3) Other malignancy prior to ESKD None (referent)1.00.52 Pre-dialysis malignancy0.9 (0.7-1.2) Smoking history at ESKD Never (referent)1.00.94 Current or former0.9 (0.9-1.2) Diabetes at ESKD No diabetes (referent)1.00.0021.0<0.001 Diabetes1.4 (1.1-1.7) 1.5 (1.2-1.8) Table 4: Risk of death for people with myeloma treated with dialysis in Australia and New Zealand 1963-2009