Predictors of quality of life in multiple myeloma patients: a multi-centered cross-sectional study

Multiple myeloma (MM) substantially impairs health-related quality of life (QoL). Evidence from low- and middle-income countries is limited, and identifying reliable predictors of QoL is essential to guide supportive care strategies.

We conducted a multicenter cross-sectional study of 202 MM patients from six hospitals in the West Bank, Palestine (2018-2025). Patients completed the validated Arabic EORTC QLQ-MY20 questionnaire. Clinical, demographic, and therapeutic variables were collected, and predictors of QoL subscales were analyzed using non-parametric tests and multivariable linear regression with LASSO variable selection.

In the Side Effects of Treatment subscale, abdominal pain (β = 6.75; 95% CI: 1.92-11.59; p = 0.006), chest pain (β = 9.63; 95% CI: 4.25-15.01; p < 0.001), and swelling (β = 8.15; 95% CI: 2.90-13.40; p = 0.002) were strong independent predictors, while autoimmune disease and peptic ulcer showed borderline associations. For the Body Image subscale, gout (β = - 22.06; 95% CI: - 38.95 to - 5.18; p = 0.010) and peptic ulcer (β = - 25.82; 95% CI: - 47.18 to - 4.46; p = 0.018) significantly worsened patient perceptions, with serum calcium showing a borderline effect (p = 0.052). In the Future Perspective subscale, chest pain demonstrated a borderline negative association (β = - 8.15; 95% CI: - 16.72 to 0.42; p = 0.062), while other predictors showed no significant effects. LASSO models confirmed stable predictor sets with low multicollinearity, explaining 25.9% (SE), 10.5% (Body Image), and 2.4% (Future Perspective) of variance, respectively.

Specific symptoms (abdominal pain, chest pain, swelling) and comorbidities (gout, peptic ulcer disease) emerged as important determinants of QoL in MM patients. Cardiopulmonary complaints also suggested a psychological burden on future outlook. These findings highlight the need for integrated symptom management and comorbidity-focused supportive care, particularly in resource-limited healthcare systems such as Palestine.