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Updated: Aug 30, 2025
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Palliative care utilization, transfusion burden, and end-of-life care for patients with multiple myeloma
Geoffrey McInturf1, Kimberly Younger1, Courtney Sanchez1
1School of Medicine, University of Kansas Medical Center, Lawrence, Kansas, USA.
Introduction:
Despite treatment advances, multiple myeloma (MM) remains a significant source of morbidity and mortality. We aimed to examine specialist palliative care (SPC) involvement and end-of-life care for patients with MM.
Methods:
We assessed all deceased patients with a diagnosis of MM who received care at a single institution from January 2010 to December 2019 and assessed SPC involvement.
Results:
We reviewed 456 deceased patients. Overall, 207 patients (45.4%) received SPC visits by clinicians during their disease, and 153 (33.5%) were on MM treatment in the month before death. Median time from SPC consultation to death was 1 month, with 42 (9.2%) of patients receiving SPC visits 6 or more months before death. Amongst the patients for which a place of death was reported (351), 117 (33.3%) died in the acute care setting. Outpatient SPC did not correlate with a reduction of death in the acute care setting. In the group of patients who received outpatient SPC, 22/84 (26.2%) died in an acute care setting, whereas 95/267 (35.5%) patients who did not receive outpatient SPC also died in an acute care setting, (p = .11).
Conclusion:
In our analysis of the entire trajectory of the MM patient experience from diagnosis to death, we found low rates of SPC involvement and a significant proportion of patients receiving aggressive care at end-of-life. While there is no clear correlation that SPC involvement impacted the rate of acute care deaths or decreased utilization of MM treatment in the last month of life, further prospective research on optimal utilization of SPC is required.
Insights
Specialist palliative care (SPC) involvement was low in multiple myeloma (MM) patients, with many receiving aggressive end-of-life care. SPC did not significantly impact acute care deaths or late-stage treatment. Further research is needed.
Area of Science:
- Oncology
- Palliative Care
- Health Services Research
Background:
- Multiple myeloma (MM) presents significant morbidity and mortality despite treatment advances.
- Specialist palliative care (SPC) plays a crucial role in managing complex symptoms and improving quality of life for cancer patients.
- Understanding SPC involvement in MM is vital for optimizing end-of-life care.
Purpose of the Study:
- To examine the extent of specialist palliative care (SPC) involvement in patients with multiple myeloma (MM).
- To assess end-of-life care patterns, including place of death and treatment utilization, in MM patients.
- To investigate the correlation between SPC involvement and end-of-life outcomes in MM.
Main Methods:
- Retrospective analysis of deceased MM patients from January 2010 to December 2019 at a single institution.
- Assessment of specialist palliative care (SPC) consultation records and timing relative to death.
- Evaluation of place of death and MM treatment status in the final month of life.
Main Results:
- 45.4% of 456 deceased MM patients received SPC visits.
- Median time from SPC consultation to death was 1 month; only 9.2% received SPC 6+ months prior.
- 33.3% of patients died in an acute care setting; SPC did not significantly reduce acute care deaths.
Conclusions:
- Low rates of SPC involvement and significant aggressive end-of-life care were observed in MM patients.
- SPC involvement did not demonstrate a clear correlation with reduced acute care deaths or decreased late-stage MM treatment.
- Further prospective research is warranted to determine optimal SPC utilization strategies for MM patients.
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