ArticleCancers2025
A Prognostic Symptom Model Incorporating Patient-Reported Symptoms for Transplant-Ineligible Patients with Multiple Myeloma.
Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPatients with transplant-ineligible (TIE) multiple myeloma (MM) have high rates of symptom burden. The aim of this study was to develop and validate a prognostic model to predict symptoms in patients with TIE MM.
methodsIn this population-based, retrospective cohort study, using multiple administrative health care databases linked using a unique encrypted patient identifier in Ontario, Canada, symptoms were identified using the patient self-reported Edmonton Symptom Assessment System (ESAS) at each clinic visit. The primary outcome was the presence of moderate-to-severe (ESAS score 4-10) symptoms (specifically symptoms of pain, tiredness, depression, and impaired well-being) within one year from the index date. Using the entire cohort, a multivariable logistic regression model with baseline covariates was developed to predict the risk of experiencing each of the above symptoms, categorized as moderate to severe within 1 year post-index date. Internal validation of the model was assessed via bootstrap validation methods.
resultsA total of 1535 TIE adults with MM met the inclusion criteria. The median age was 75, with 25.2% of patients aged 80 years or older. In the multivariate analysis, baseline symptoms continued to be most associated with future symptom burden. Baseline severe pain (OR 9.84, 95% CI 6.29-15.7) was most associated with patients experiencing moderate-severe pain one year post-index date. Similarly, baseline severe tiredness (OR 17.34, 95% CI 9.00-33.42), baseline severe depression (OR 28.07, 95% CI 15.96-49.38), and baseline severely impaired well-being (OR 4.12, 95% CI 2.30-7.37) were the biggest predictors of patients experiencing moderate-severe tiredness, depression, and impaired well-being, respectively, at one year after the index date.
conclusionsPatients with MM experience persisting symptoms of pain, tiredness, depression, and impaired well-being, with baseline symptoms being the biggest predictor of future symptom burden.
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