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Current Oncology
Volume 23
Issue 6
10.3747/co.23.3298
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Risk Stratification, Treatment Selection, and Transplant Eligibility in Multiple Myeloma: A Qualitative Study of the Perspectives and Self-Reported Practices of Oncologists

by
T.W. LeBlanc
1,2,*,
A. Howson
3,
W. Turell
3,
P. Sheldon
3,
S.C. Locke
2,
S.A. Tuchman
1,
C. Gasparetto
1,
S. Kaura
4,
Z.M. Khan
4 and
A.P. Abernethy
2
1
Duke Univ, Sch Med, Div Hematol Malignancies & Cellular Therapy, Dept Med, Durham, NC, USA
2
Duke Univ, Sch Med, Duke Canc Inst, Durham, NC, USA
3
Opus Sci, Annapolis, MD, USA
4
Celgene Corp, Summit, NJ, USA
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(6), 598-604; https://doi.org/10.3747/co.23.3298
Submission received: 4 September 2016 / Revised: 3 October 2016 / Accepted: 2 November 2016 / Published: 1 December 2016

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

Share and Cite

MDPI and ACS Style

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. 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, 598-604. https://doi.org/10.3747/co.23.3298

AMA Style

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. Current Oncology. 2016; 23(6):598-604. https://doi.org/10.3747/co.23.3298

Chicago/Turabian Style

LeBlanc, T.W., A. Howson, W. Turell, P. Sheldon, S.C. Locke, S.A. Tuchman, C. Gasparetto, S. Kaura, Z.M. Khan, and A.P. Abernethy. 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 23, no. 6: 598-604. https://doi.org/10.3747/co.23.3298

APA Style

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, 23(6), 598-604. https://doi.org/10.3747/co.23.3298

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