Purpose: Multiple myeloma (MM) is increasingly recognised across sub-Saharan Africa, yet major disparities persist in access to diagnostics, treatment and supportive care. This study assesses real-world clinical practices, guideline adherence and perceived barriers to optimal MM management among haematologists in Nigeria.
Methods: A cross-sectional, nationwide online survey was administered to Nigerian haematologists managing patients diagnosed with MM. Data were collected on clinician demographics, diagnostic approaches, treatment regimens, use of guidelines, venous thromboembolism (VTE) and infection prophylaxis and perceived challenges. Descriptive statistics were used to analyse results.
Results: Eighty-six clinicians participated. Most worked in tertiary hospitals and managed 0–5 MM patients per month. The most common presenting features were anaemia (91.9%), bone pain (88.4%) and renal impairment (59.3%). Triple-drug induction regimens were preferred by 94.2% of clinicians, with bortezomib, lenalidomide and dexamethasone being the most frequently prescribed. Financial constraint was the major determinant of regimen choice (77.9%). Maintenance therapy (89.5%) and bisphosphonate use (89.5%) were widely adopted. VTE risk assessment was routinely performed by 69.8% of respondents. Major barriers to MM care included high treatment cost (90.7%), limited access to novel therapies (70.9%) and lack of autologous stem cell transplantation (ASCT) services (68.6%).
Conclusion: Haematologists in Nigeria demonstrated strong alignment with international standards; however, systemic barriers including cost, diagnostic limitations and lack of ASCT and novel agents impede optimal care delivery. Policy reforms, subsidised treatment access, expanded diagnostic infrastructure and MM-specific training are recommended.
