Impact of Polypharmacy on Prognosis in Lymphoma, CLL, and MM Patients

In a pivotal study published in HemaSphere on July 29, 2025, researchers have identified the number of medications a patient takes as a significant prognostic indicator for outcomes in patients with lymphoma, chronic lymphocytic leukemia (CLL), and multiple myeloma (MM). The research, led by Dr. Christian Brieghel, MD, PhD, of the Danish Cancer Institute, underscores the importance of assessing polypharmacy—defined as the concurrent use of five or more medications—when evaluating patient health outcomes in these cancers.

The study analyzed a comprehensive dataset from the Danish prescription registry, which included medication histories of 46,803 newly diagnosed patients over the year prior to their cancer diagnosis. The researchers aimed to explore whether the sheer number of prescriptions could serve as a reliable proxy for assessing patients' comorbidity burden, which is known to impact treatment options and overall survival rates.

According to the findings, patients engaged in polypharmacy exhibited a higher risk of adverse outcomes, including increased mortality and hospitalization rates. The hazard ratios (HR) indicated that patients taking up to three medications had a baseline HR of 1.0 for overall survival, while those on four to seven medications experienced an HR of 1.2, and patients on eight to eleven medications had an HR of 1.4. Alarmingly, those prescribed more than eleven medications faced an HR of 1.9, suggesting a nearly doubled risk of poor outcomes.

Dr. Brieghel and colleagues noted that the types of medications also played a role in prognostic significance. Specifically, immunostimulants and blood substitutes were associated with a negative impact on overall survival, while gynecological and sex hormone medications correlated with more favorable outcomes. This trend was particularly noticeable in younger, female patients, who typically presented a more positive prognosis.

The implications of this research extend to clinical practice, as the authors advocate for the integration of medication count as a baseline characteristic in clinical trials and treatment planning for lymphoma, CLL, and MM patients. Despite the strong association between medication count and patient outcomes, the researchers were careful to note that their study was not designed to establish causality.

Previous studies have corroborated these findings, indicating that polypharmacy is linked to increased mortality and adverse drug reactions among older adults. For instance, a systematic review published in the Archives of Gerontology and Geriatrics in 2022 highlighted similar concerns regarding the risks associated with polypharmacy in aging populations.

As the healthcare community grapples with the growing prevalence of polypharmacy, particularly among older patients with complex health profiles, this study reinforces the need for careful medication management and the potential for refining treatment strategies based on comprehensive medication assessments. The research paves the way for future investigations aimed at understanding the nuanced interplay between medication use and patient outcomes in lymphoid cancers.

In conclusion, this groundbreaking study underscores the critical role of medication management in improving health outcomes for patients with lymphoma, CLL, and MM. As the medical community continues to evolve its understanding of cancer treatment and patient care, the findings call for a more nuanced approach to prescribing practices that take into account not only the effectiveness of cancer therapies but also the broader impact of polypharmacy on patient health and survival.