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LeBlanc TW, Howson A, Turell W, et al. Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists. Curr Oncol. 2016;23(6):e598-e604doi: 10.3747/co.23.3298.
LeBlanc, T. W., Howson, A., Turell, W., Sheldon, P., Locke, S. C., Tuchman, S. A., Gasparetto, C., Kaura, S., Khan, Z. M., & Abernethy, A. P. (2016). Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists. Current oncology (Toronto, Ont.), 23(6), e598-e604. https://doi.org/10.3747/co.23.3298
LeBlanc, T W, et al. "Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists." Current oncology (Toronto, Ont.) vol. 23,6 (2016): e598-e604. doi: https://doi.org/10.3747/co.23.3298
LeBlanc TW, Howson A, Turell W, Sheldon P, Locke SC, Tuchman SA, Gasparetto C, Kaura S, Khan ZM, Abernethy AP. Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists. Curr Oncol. 2016 Dec;23(6):e598-e604. doi: 10.3747/co.23.3298. Epub 2016 Dec 21. PMID: 28050150; PMCID: PMC5176387.
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Curr Oncol. 2016 Dec;23(6):e598-e604. doi: 10.3747/co.23.3298. Epub 2016 Dec 21.

Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists.

Current oncology (Toronto, Ont.)

T W LeBlanc, A Howson, W Turell, P Sheldon, S C Locke, S A Tuchman, C Gasparetto, S Kaura, Z M Khan, A P Abernethy

Affiliations

  1. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, and; Duke Cancer Institute, Duke University School of Medicine, Durham, NC, U.S.A.
  2. Opus Science, Annapolis, MD, U.S.A.
  3. Duke Cancer Institute, Duke University School of Medicine, Durham, NC, U.S.A.
  4. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, and.
  5. Celgene Corporation, Summit, NJ, U.S.A.

PMID: 28050150 PMCID: PMC5176387 DOI: 10.3747/co.23.3298

Abstract

BACKGROUND: Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care.

METHODS: We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel. We conducted 60-minute interviews with a diverse sample of oncology physicians in the southeast United States. We used a constant comparative method to code and analyze interview transcripts. The research team and advisory panel discussed and validated emergent themes.

RESULTS: Participants were 13 oncologists representing 5 academic and 4 community practices. Academic physicians reported using formal risk-stratification schemas; community physicians typically did not. Physicians also described differences in eligibility criteria for transplantation; community physicians emphasized distance, social support, and psychosocial capacity in making decisions about transplantation referral; the academic physicians reported using more specific clinical criteria. All physicians reported using a maintenance strategy both for post-transplant and for transplant-ineligible patients; however, determining the timing of maintenance therapy initiation and the response were reported as challenging, as was recognition or definition of relapse, especially in terms of when treatment re-initiation is indicated.

CONCLUSIONS: Practices reported by both academic and community physicians suggest opportunities for interventions to improve patient care and outcomes through optimal multiple myeloma management and therapy selection. Community physicians in particular might benefit from targeted education interventions about risk stratification, transplant eligibility, and novel therapies.

Keywords: Multiple myeloma; qualitative research; risk stratification; treatment decision-making

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