Session: 905. Outcomes Research—Lymphoid Malignancies: Poster II
Hematology Disease Topics & Pathways:
Research, adult, Lymphomas, Clinical Research, health outcomes research, Plasma Cell Disorders, Diseases, Lymphoid Malignancies, Study Population, Human
Methods: In July 2021, we initiated a 44-item survey to characterize anxiety and depression among patients with new diagnoses of lymphoma or myeloma recruited from a large cancer center. Eligible patients were ≥ 18 years and within 6 months of their initial cancer diagnosis. Participants could complete the survey online or on paper. We developed the survey from a literature review and with cognitive debriefing of 6 patients newly diagnosed with either malignancy. The survey included the Hospital Anxiety and Depression Scale (subscale range 0- 21; cutoff scores >7 indicating anxiety or depression); the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 overall quality of life (QOL) scale (range 1-7, with higher scores indicating better QOL); and the modified Medical Outcomes Study-Social Support scale (range 0-100; with higher scores indicating more social support). We characterized sociodemographic factors associated with anxiety and depression in univariable analysis, and then built multivariable logistic regression models including factors with p<0.05 to assess variables independently associated with each outcome. We also assessed the potential relationship of anxiety and depression with QOL. Two-sided p values <0.05 were considered significant.
Results: As of July 2022, 192 of 238 patients approached had completed the survey (response rate: 80.7%). The median age of responders was 60 years (interquartile range [IQR] 49, 69). Most (80.2%) had lymphoma, with 19.8% myeloma. The majority of respondents were male (55.2%), White (85.9%), and married or living with a partner (73.4%; Table). Over half of the cohort (56.3%) had anxiety and/or depression with 51.6% of respondents meeting the cutoff for anxiety, and 27.6% for depression. In univariable analysis, age ≤ 60 years, female gender, being unmarried/not living with a partner, lack of extra money at the end of the month, not being “very/completely satisfied” with finances, and a social support score below the mean were associated with higher likelihood of experiencing anxiety. In multivariable analysis, age ≤ 60 years (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.17-4.29), female gender (OR 2.29 95% CI 1.18-4.46), and low financial satisfaction (OR 2.24, 95% CI 1.01-4.98) remained significantly associated with higher odds of anxiety. Patients with anxiety were more likely to report lower QOL compared to those without anxiety (mean [SD]: 4.75 [1.39] vs. 5.65 [1.25], p< 0.001). In univariable analysis, patients who reported a social support score below the mean and those who reported not being “very/completely satisfied” with their finances were more likely to have depression. In multivariable analysis, low social support (OR 2.28, 95% CI 1.15-4.51) and low levels of satisfaction with finances (OR 2.61, 95% CI 1.30-5.22) were significantly associated with experiencing depression. Patients with depression also reported lower QOL versus those without depression (3.96 [1.22] vs. 5.65 [1.16], p< 0.001).
Conclusions: In this large cohort of patients newly diagnosed with lymphoma or myeloma, we found a substantial psychological burden, with the majority experiencing anxiety and/or depression. We found a strong association of these symptoms with lower QOL for patients living with a new blood cancer, suggesting that interventions aimed at managing psychosocial distress could improve the lived experience of these diseases in their peri-diagnostic phase. Moreover, the association of financial burden and lower social support with depression suggests a critical need for psychosocial interventions to specifically target these factors.
Disclosures: Abel: Novartis: Consultancy.
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