The impact of forced internal displacement due to the full-scale russian invasion in Ukraine on the multiple myeloma (MM) patients’ survival and quality of life (QoL): the real-life observational study

Abstract

Context: The beginning of a full-scale invasion and active hostilities in Ukraine after February 24, 2022, caused mass displacement - citizens left their homes in search of safety and protection. Currently, the number of officially registered internally displaced persons (IDP) in Ukraine reaches 4.9 million people. This fact and newly diagnosed multiple myeloma (MM) may significantly influence a patient’s quality of life (QoL) and survival. Aim: The primary endpoint was to assess the overall survival (OS) of MM patients who were internally displaced from the territories of active hostilities to Poltava region. The second endpoint was to assess their QoL. Materials and Methods: Our study included 84 primary patients with MM during 2022–2023 after the full-scale Russian invasion of Ukraine. Median age, 64.6 ± 7.57 years; male, 46 (54.8%); female, 38 (45.2%); and ECOG 0–2. The patients were divided into two groups: Group 1 (N = 60), native citizens of the Poltava region, and Group 2 (N = 24), IDP from regions of active hostilities (Kharkiv, n = 11; Donetsk, n = 8; Sumy, n = 3; Luhansk, n = 2). The 2-year OS was assessed and QoL was evaluated by EQ- 5D-5L with descriptive data and visual analog scoring (EQ-VAS). Results: The 2-year OS was 56% in citizens native to the Poltava Region (Group 1) and 22% in IDP withMM(Group 2; hazard ratio [HR], 2.338; 95% CI, 1.17–4.68; P = 0.0162). There was no significant difference between patients in the two groups in impairments of mobility, self-care, and pain/discomfort data. The usual activities, such as work, study, housework, family or leisure activities, were significantly impaired in Group 2 patients compared to Group 1 (X2[1, N = 84] = 10.14, P < 0.04). Additionally, the results showed an increased level of anxiety/depression in patients of Group 2 who had moved to the Poltava region due to active hostilities (X2[1, N = 84] = 24.9, P = 0.000053). EQ-VAS data for Group 2 patients was significantly lower compared with Group 1 reported parameters (57.02 ± 9.88 vs 69.92 ± 7.86; P = 0.00001).