e18232 Background: Few studies have evaluated the impacts of depressive symptoms and mental health on patients diagnosed with multiple myeloma (MM). The aim of this study was to examine associations between depressive symptoms and poor mental health-related quality of life in relation to survival in a cohort of older MM patients. Methods: We conducted an analysis using a prospective cohort from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) of patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014. Subjects were required to have completed at least 1 pre-diagnosis survey and depressive symptoms were determined based on positive responses to at least 1 of 3 depression screening questions. Veterans-RAND-12 mental component scores (MCS) were also analyzed to evaluate mental health-related quality of life. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between pre-diagnosis depressive symptoms and risks of all-cause and cancer-specific mortality. Secondary analyses examined mortality risks in relation to pre-diagnosis MCS. Results: Of 522 multiple myeloma patients, the mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) self-reported positive 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). Myeloma patients scoring in the second MCS tertile (versus 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. Conclusions: Pre-diagnosis depressive symptoms and lower mental health-related quality of life are not associated with survival for MM. Nevertheless, the considerably high prevalence of depressive symptoms and poor mental health status among older patients with multiple myeloma deserves clinical attention.
Impact of elotuzumab treatment on pain and health-related quality of life in patients with relapsed or refractory multiple myeloma: results from the ELOQUENT-2 study