Persistent opioid use in patients with multiple myeloma post-ASCT

Area of Science:

• Hematology
• Oncology
• Pain Management

Background:

• Bone pain is a frequent symptom in multiple myeloma (MM).
• Opioids are commonly used for pain management in MM patients alongside anti-myeloma therapies.
• Improved survival in MM necessitates re-evaluation of opioid use in symptomatic patients.

Purpose of the Study:

• To analyze opioid use patterns in MM patients undergoing autologous stem cell transplant (ASCT).
• To investigate the correlation between opioid use, treatment response, and patient characteristics.
• To assess the persistence and changes in opioid use post-ASCT.

Main Methods:

• Retrospective analysis of 138 MM patients who underwent ASCT between 2012 and 2017.
• Data collected at pre-ASCT, 100-day, and 1-year post-ASCT follow-up visits.
• Comparison of opioid users and non-users regarding treatment response, comorbidities, and symptoms.

Main Results:

• 34.8% of patients used opioids before ASCT, more common in younger patients and those with bone lesions.
• 31.9% of patients continued opioid use at 1-year post-ASCT; use was not correlated with disease response.
• 58% of patients using opioids at transplant either maintained or increased their dose by 1-year post-transplant.

Conclusions:

• Opioid use remains prevalent in MM patients, associated with younger age and bone involvement, not treatment response.
• A significant proportion of MM patients continue or escalate opioid use after ASCT.
• Distinguishing cancer pain from chronic pain is crucial given increased MM survival.