Symptom Burden and Quality of Life in Multiple Myeloma: A Multicenter Study

Introduction Symptom burden is a critical determinant of treatment tolerance and survivorship in multiple myeloma (MM). We investigated how symptom severity and interference relate to patient-reported quality of life (QoL) across multiple domains in a multicenter real-world MM cohort. Methods This multicenter study included 250 previously treated patients with multiple myeloma recruited from six hospitals in the West Bank, Palestine.Symptom severity and interference were assessed at baseline using the MDASI-MM, and QoL was evaluated one month later with the FACT-MM. Multivariable linear regression adjusted for demographic and clinical covariates was applied. Results are reported as adjusted β coefficients with 95% confidence intervals, and a two-sided P<0.05 was considered statistically significant. Results Greater symptom burden was consistently associated with poorer quality of life. General, specific, and overall symptom severity showed the strongest associations with lower physical well-being, disease-specific concerns, pain-related quality of life, Trial Outcome Index, and FACT-MM total score. Specific symptoms were also associated with lower social well-being. Symptom interference domains showed similar but smaller associations, particularly with physical well-being, functional well-being, pain, and composite quality-of-life scores. Conclusion In this multicenter cohort of patients with multiple myeloma, higher symptom burden was consistently associated with poorer quality of life, especially in physical functioning, pain, and disease-specific concerns. Routine symptom monitoring may help identify patients who need early supportive care interventions.