Patient Preferences for Treatment‑Free Intervals in Multiple Myeloma: Mixed‑Methods Insights on Monitoring Trade‑offs and Supportive Care Improvements

Purpose Continuous therapy in multiple myeloma (MM) can impose cumulative toxicities and psychosocial burden. This mixed‑methods study quantified patient preferences for treatment‑free intervals (TFIs), monitoring trade‑offs, and actionable service improvements across inpatient and outpatient care. Methods A 12-month, single-center mixed-methods survey (n = 100) at a German tertiary center collected sociodemographics, treatment exposure, and structured items on TFI importance, preferred TFI length, monitoring intensity, relapse-risk trade-offs, inpatient stressors, and patient-generated improvement proposals. Quantitative analyses comprised descriptive statistics and hypothesis‑driven group comparisons; qualitative data were analyzed using inductive thematic analysis with double‑coding and consensus. Results TFIs between inpatient treatments were rated 10/10 “very important” by 49.5% and 0/10 “not important” by 9.1%. Predominant inpatient stressors were separation from family (27%), treatment‑related symptoms/side effects (23%), fatigue (17%), food quality (15%), waiting times (14%), and shared rooms (12%). In the outpatient setting, 77% found regular check‑ups reassuring, while 13% found them burdensome. When trading TFI length against relapse risk, 67% prioritized risk minimization and 7% would accept higher risk for longer TFIs. Preferred minimal TFIs were < 4 weeks (23%), 4–8 weeks (19%), and > 8 weeks (39%). Narratives emphasized physical/emotional recovery, autonomy, restoration of routines, and pragmatic levers (single rooms, better food, shorter waits, flexible scheduling, staffing). Conclusion People living with MM value TFIs - especially post‑inpatient - for recovery, while favoring vigilant, risk‑adapted monitoring. Preference‑sensitive TFI planning with explicit safety triggers and hybrid in‑person/telehealth follow‑up may enhance quality of life without compromising safety.