Patients with multiple myeloma (MM) undergoing treatment experience significantly impaired quality of life (QOL) and elevated psychological distress across the disease continuum. Interventions are needed to improve patients’ QOL, reduce their psychological distress, and cultivate adaptive coping strategies. These findings from a multicenter study were presented at the 2021 American Society of Hematology (ASH) Annual Meeting.

The researchers conducted a cross-sectional, multisite study of 180 patients undergoing treatment for MM, excluding maintenance therapy, between June 2020 and January 2021. They found that regardless of their line of therapy patients endured diminished QOL and elevated stress levels. The majority reported that their oncologist had told them that their cancer is incurable. Yet, a substantial proportion still reported that they believed they were curable.

This cohort included 60 patients with newly diagnosed MM, 60 who had received 2 to 3 lines of therapy, and 60 who had received 4 or more lines of therapy. The study results showed no statistically significant differences in depression, anxiety, or PTSD symptoms by line of therapy. The rates of clinically significant depression and anxiety were 23.9% (43 patients) for each. PTSD symptoms were reported in 24.4% (44 patients).

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No serious gaps in communication were observed and 84% of patients reported that knowing their prognosis was “extremely” or “very” important, and 66.1% stated that they had received adequate information about their prognosis. The majority reported that prognostic information was “extremely” or “very” helpful in making decisions about treatment (93.4%). The same was true for coping with their disease (87.4%), and being properly prepared for the future (86.8%).

Although 84.7% of the patients reported that their oncologist told them their cancer was incurable, only 30.6% acknowledged being terminally ill and only 42.0% thought their cancer was incurable. Those who received 2 to 3 lines of therapy were more likely to acknowledge their terminal illness (36.7% vs 19.6%) and that their disease was incurable, compared with those receiving first-line therapy (36.7% vs 19.6% and 90.0% vs. 75.9%, respectively). The study results showed that QOL and psychological distress were not associated with patients’ perception that their disease was incurable, but patients who acknowledged their terminal illness reported higher depression (B=1.52), anxiety (B=1.52), symptom burden (B=7.42, and lower QOL (B=-14.78).


O’Donnell EK, Shapiro Y, Nadeem O, et al. Quality of life, psychological distress, and prognostic awareness in patients with multiple myeloma. Presented at ASH 2021; December 11-14, 2021. Abstract 4082.