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Depressive symptoms, mental health-related quality of life, and survival among older patients with multiple myeloma

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Abstract

Purpose

To examine the impact of pre-diagnosis depressive symptoms and mental health-related quality of life (HRQOL) on survival among older patients with multiple myeloma (MM).

Methods

We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data resource. Patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014 were identified, and presence of depressive symptoms was determined based on responses to 3 depression screening questions prior to MM diagnosis. Veterans RAND 12 mental component summary (MCS) scores were analyzed to evaluate mental HRQOL. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of all-cause and cancer-specific mortality.

Results

Of 522 patients, mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) reported depressive symptoms. Patients with depressive symptoms had a higher number of comorbid conditions and nearly all (84%) scored below the median MCS. Pre-diagnosis depressive symptoms were not associated with all-cause (HR = 1.01, 95% CI 0.79–1.29) or cancer-specific mortality (HR = 0.94, 95% CI 0.69–1.28). MM patients scoring in the second MCS tertile (vs the highest tertile) had a modestly increased risk of all-cause (HR = 1.19, 95% CI 0.91–1.55) and cancer-specific mortality (HR = 1.17, 95% CI 0.86–1.60), but these estimates were not statistically significant.

Conclusion

Pre-diagnosis depressive symptoms and lower mental HRQoL did not impact survival among older MM patients. Highly prevalent depressive symptoms among older MM patients deserve clinical attention. Such efforts can inform clinicians in tailoring care for this vulnerable population.

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Data availability

The authors have full control of all primary data. The data that support the findings of this study are available from the SEER-Medicare Health Outcomes Survey data resource. Restrictions apply to the availability of these data, which were used under license for this study.

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Acknowledgments

This study used data from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) linked data resource. The authors acknowledge the efforts of the National Cancer Institute; the Centers for Medicare and Medicaid Services; MHOS; Information Management Services, Inc.; and the SEER Program tumor registries in the creation of the SEER-MHOS database. The National Cancer Institute provided suggested edits and approval of the manuscript before final journal submission.

Funding

Dr. Patel received consultancy (Celgene, Janssen) and honoraria (Celgene, Janssen, Amgen). Dr. Calip was supported by the National Institutes of Health, National Center for Advancing Translational Sciences, through grant number KL2TR002002 and the National Heart, Lung and Blood Institute through grant number R21HL140531. Dr. Chiu was supported by the National Cancer Institute through grant number R01CA223662. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA

    Ali Alobaidi, Nadia A. Nabulsi, Brian Talon, Alemseged A. Asfaw, Jifang Zhou, Lisa K. Sharp & Gregory S. Calip

  2. Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA

    Karen Sweiss

  3. Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Pritesh R. Patel

  4. Section of Hematology Oncology, Boston University School of Medicine, Boston, MA, USA

    Naomi Y. Ko

  5. Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA

    Brian C.-H. Chiu

  6. Division of Public Health Sciences, Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Gregory S. Calip

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  1. Ali Alobaidi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Ali Alobaidi, Nadia A. Nabulsi, and Gregory S. Calip. The first draft of the manuscript was written by Ali Alobaidi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gregory S. Calip.

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Ethical approval

The data used in the present study were de-identified and compliant with the Health Insurance Portability and Accountability Act; this study was determined to be exempt by the Institutional Review Board of the University of Illinois at Chicago.

Informed consent

The Institutional Review Board of the University of Illinois at Chicago determined this study to be exempt from obtaining informed consent from individual participants.

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The authors declare that they have no competing interests.

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Alobaidi, A., Nabulsi, N.A., Talon, B. et al. Depressive symptoms, mental health-related quality of life, and survival among older patients with multiple myeloma. Support Care Cancer 28, 4097–4106 (2020). https://doi.org/10.1007/s00520-019-05246-6

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