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High symptom burden in transplant-ineligible patients with newly diagnosed MM

Presented by
Dr Hira Mian, McMaster University, Canada
ASH 2020
“Despite many advances in therapeutics, transplant-ineligible patients with multiple myeloma (MM) still experience high symptom burden,” Dr Hira Mian (McMaster University, Canada) stated. “Our results demonstrate that this is especially the case during the first 3 months following diagnosis. Although there is an improvement, even at the 1-year mark, a significant symptom burden remained.”

Patient-reported outcomes (PROs) represent an opportunity to both understand the magnitude as well as the temporal trend of symptom burden. The presented study investigated PROs, assessed by the Edmonton Symptoms Assessment System (ESAS) scores, from transplant-ineligible patients with newly diagnosed MM [1]. ESAS is a validated outcome tool assessing the severity of 9 common cancer-associated symptoms: well-being, pain, tiredness, anxiety, depression, drowsiness, lack of appetite, nausea, and shortness of breath. Patients report symptoms from 0 (no symptoms) to 10 (worst symptoms), with score ≥4 representing clinically significant moderate-to-severe symptoms.

In this retrospective study, a high proportion of the cohort (n=2,876) reported moderate-to-severe symptoms at diagnosis, with tiredness (64%) and impaired well-being (60%) being among the most prevalent and nausea being the least prevalent (13%). Most symptoms decreased over the first year, with the largest decline happening in the first 3 months. One year after diagnosis, over 25% of the cohort still reported ≥1 of the following moderate-to-severe symptoms: tiredness, pain, impaired well-being, drowsiness, or loss of appetite. Self-reported depression rates marginally decreased over time but were still at 18% after 1 year. “In our study, we were also able to identify a number of factors that are associated with high symptom burden,” Dr Mian continued. “These included lower age, female sex, urban geographic location, poor socioeconomic status, and earlier year of diagnosis.”

This study represents the largest longitudinal study to date on symptom burden among patients with MM using PROs. Future studies aimed at targeted intervention are needed early in the disease course to alleviate symptom burden for at-risk patient groups.

  1. Mian HS, et al. Symptom Burden in Transplant Ineligible Patients with Newly Diagnosed Multiple Myeloma: A Population-Based Study of Patient-Reported Outcomes. 62nd ASH Annual Meeting, 5-8 December 2020. Abstract 439.

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