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. 2021 Feb;21(2):e152-e159.
doi: 10.1016/j.clml.2020.09.010. Epub 2020 Oct 1.

Burden of Treatment Among Older Adults With Newly Diagnosed Multiple Myeloma

Hira S Mian  1 , Mark A Fiala  2 , Tanya M Wildes  3
Affiliations

Burden of Treatment Among Older Adults With Newly Diagnosed Multiple Myeloma

Hira S Mian et al. Clin Lymphoma Myeloma Leuk. 2021 Feb.

Abstract

Background: Multiple myeloma is an incurable hematologic malignancy with significant recent treatment advances; however, the magnitude of treatment burden among patients in the first year after diagnosis has yet to be fully researched and reported.

Patients and methods: Patients with multiple myeloma newly diagnosed between 2007 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Treatment burden was captured as the number of total days with a health care encounter (including acute care and outpatient visits), oncology and nononcology physician visits, and the number of new prescriptions within the first year after diagnosis. Logistic regression was used to identify factors associated with high treatment burden.

Results: A total of 3065 patients were included in the analysis. There was a substantial burden of treatment within the first year after diagnosis (median, 77 days; interquartile range, 55-105 days), which was highest during the first 3 months. Patients with high comorbidities (adjusted odds ratio [aOR] 1.27 per 1-point increase in Charlson comorbidity index, P < .001), poor performance status (aOR 1.85, P < .001), myeloma-related end organ damage, particularly bone disease (aOR 2.28, P < .001), and those who underwent autologous stem-cell transplantation (aOR 2.41, P < .001) were more likely to have a higher treatment burden.

Conclusion: There is considerable burden of treatment in patients with newly diagnosed multiple myeloma within the first year after diagnosis, particularly within the first 3 months. Future tailored interventions aimed at optimizing this treatment burden when possible while simultaneously providing support to manage it may improve patient-centered care.

Keywords: Aged; Healthcare utilization; Hematologic malignancy; Quality of life; Supportive care.

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Figures

Figure 1
Figure 1
Selection of Study Cohort
Figure 2
Figure 2
Number of Total Health Care Encounters Among Adults With NDMM in First 12 Months After Diagnosis. Data are shown as mean with standard deviation Abbreviation: NDMM = newly diagnosed multiple myeloma.
See this image and copyright information in PMC

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