Reviewed by Christopher Su, MD, MPH Assistant Professor, Division of Hematology and Oncology University of Washington Fred Hutchinson Cancer Center Seattle, WA
Dr. Su has no relevant financial relationships to disclose.
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Multiple myeloma has been associated with improved overall survival at the VA since 2000.1 Advances in diagnostics, response assessment (eg, minimal residual disease detection), and novel therapies (eg, autologous stem cell transplant and cellular immunotherapy) have likely contributed to this increase.1-3 However, tobacco use, military exposures, and older age at diagnosis still correlate with negative outcomes.1
SEER, Surveillance, Epidemiology, and End Results Program.
Despite a large shift from in-person to virtual care at the start of the pandemic, the nonsignificant trends in inpatient admissions and numbers of oral prescriptions for multiple myeloma suggest that there were no drastic changes in quality of care—although longer-term impacts on survival and quality-of-life measures have yet to be observed.
Multiple myeloma treatment takes a toll on patients and caregivers. Recent surveys have found that both groups have significant rates of anxiety and depression, as well as misconceptions about disease prognosis that may cause further distress as treatment progresses. This highlights the importance of ongoing open dialogue and detailed discussions among physicians, patients, and caregivers.
Although CAR T-cell therapy has been a revolutionary breakthrough in the treatment of relapsed/refractory hematologic malignancies, significant barriers to equitable care remain. Among these include racial underrepresentation in clinical trials, affordability, and long distances to facilities offering CAR T-cell therapy.
