ABSTRACT
Introduction:
Late presentation of
multiple myeloma (MM) heightens the
risk of complication
risks, including end-organ damage. This study aimed to 1) detail the diagnostic journey of MM
patients, encompassing symptoms, initial
diagnoses, and
healthcare professionals met; 2) establish the median duration from symptom onset to MM
diagnosis; and 3) examine factors linked to timely MM
diagnosis within 12 weeks.
Methods:
A total of 300
adults self-
reporting MM were analysed from the Rare and
Undiagnosed Diseases cohort Study (RUDY). The RUDY study is a web-based platform, where participants provide dynamic consent and self-report their MM
diagnosis and information about their diagnostic journey. This includes the estimated date of initial potential first symptoms, descriptions of these symptoms, the
healthcare professionals they consulted, and other
diagnoses received before the MM
diagnosis. Descriptive
statistics, combinatorial analyses and
logistic regression analyses were used to describe and examine the diagnostic journey of individuals with MM.
Results:
Overall, 52% of the participants reported other
diagnoses before MM
diagnosis, with musculoskeletal disorders (47.8%), such as
osteoporosis, costochondritis, or
muscle strains, being the most common. The most prevalent initial reported symptom was
back pain/vertebral fractures (47%), followed by
chest/
shoulder pain, including
rib pain and fractures (20%), and
fatigue/tiredness (19.7%). 40% of participants were diagnosed by direct
referral from
primary care to haematology without seeing other
healthcare professionals whilst 60% consulted additional
specialists before
diagnosis. The median
time from symptom onset to MM
diagnosis was 4 months (IQR 2-10 months, range 0-172). Seeing an Allied
Healthcare Professional such as a
physiotherapist, chiropractor or an
osteopath (OR = 0.25, 95% CI [0.12, 0.47], p <0.001), experiencing
infection symptoms (OR = 0.32, 95% CI [0.13, 0.76], p = 0.013), and having
chest or
shoulder pain (OR = 0.45, 95% CI [0.23, 0.86], p = 0.020) were associated with a lower likelihood of being diagnosed with MM within 12 weeks. Older age (OR = 1.04, 95% CI [1.02, 1.07], p = 0.001) was associated with a higher likelihood of
diagnosis within 12 weeks.
Discussion:
Developing
resources for
allied health professionals may improve early recognition of MM.