An unmet need was to improve multiple myeloma (MM) patients’ end-of-life (EOL) care. Between 2006 and 2018, an administrative cohort in Ontario, Canada, was examined. 

At least two new hospital admissions within 30 days of a death, two or more emergency department visits within the 30 days prior to death, or an intensive care unit (ICU) admission within the final 30 days of life were considered examples of aggressive treatment. A doctor’s house call within the final two weeks of life or a palliative nursing or personal support visit within the last 30 days of life were considered supportive care. 

Of the 5,095 patients, 23.2% received chemotherapy near the end of life, and 55.6% passed away while being treated at a hospital. In contrast to the majority who got supportive therapy at EOL (65.4% ASCT, 61.5% non-ASCT), a minority (28.1%) received aggressive care at EOL [28.3%: autologous stem cell transplant (ASCT), 20.4%: non-ASCT]. Those over 80 living in lower-income neighborhoods had a reduced likelihood of receiving supportive care. From 56.0% in 2006 to 70.3% in 2018, support services at EOL grew.

Many MM patients still receive aggressive therapy at end-of-life, despite advancements. Disparities based on age, wealth, and community size exist even in a healthcare system that is publicly supported.