Digital Symptom Trackers Show Promise for Blood Cancer Care, Review Finds

Blood cancers are among the most common and fastest-growing groups of malignancies worldwide, accounting for 6.6 percent of all cancer cases and 7.2 percent of cancer deaths in 2022. Yet despite decades of progress in treating leukemia, lymphoma, and myeloma, one of the most powerful sources of clinical information has often gone untapped: the patient’s own voice. A new systematic review published in Supportive Care in Cancer suggests that digital platforms designed to capture patient-reported outcomes are beginning to change that, offering real-time symptom monitoring that could reshape how hematological cancers are managed.

The review, led by Jessica Nikolovski of the University of Sydney and colleagues, systematically examined electronic patient-reported outcome platforms, or ePROMs, used specifically in hematological cancer populations. Following PRISMA 2020 guidelines, the team searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane, supplemented by a search of the Google Play App Store. From 3,752 database records and 342 additional sources, they identified 14 distinct platforms reported across 18 studies conducted in eight countries between 2007 and 2024. Crucially, the review focused on bespoke platforms offering functionality beyond simple questionnaire administration, excluding generic survey tools such as REDCap, Qualtrics, and Google Forms that lack features like longitudinal tracking, clinician dashboards, and automated alerts.

The rationale for this technological push is grounded in the biology and treatment landscape of blood cancers. Hematological malignancies impose a heavy burden on health-related quality of life due to prolonged, intensive treatment regimens, substantial symptom loads, and psychological distress. Moreover, the therapeutic arsenal has expanded dramatically beyond traditional cytotoxic chemotherapy to include molecularly targeted agents, CAR T-cell therapies, immunotherapies, and monoclonal antibodies. Each of these carries distinct toxicity profiles that can produce unanticipated adverse events, making careful monitoring essential for informed joint decisions about treatment choice, supportive care, and dose modification.

The platforms identified in the review spanned research, clinical care, and registry settings, and targeted a diverse range of conditions. Multiple myeloma was the most commonly studied population, followed by chronic myeloid leukemia, with additional studies covering myeloproliferative neoplasms, lymphoproliferative disorders, and patients undergoing hematopoietic stem cell transplantation. Sample sizes ranged from 10 to 755 participants. The platforms captured a wide array of outcome domains, including physical symptoms, quality of life, fatigue, emotional distress, and treatment adherence, using validated instruments such as the EORTC QLQ-C30, PRO-CTCAE, PROMIS-29, and the hematology-specific HM-PRO, alongside custom-designed questionnaires.

Technically, the platforms were delivered primarily through web portals and smartphone or tablet applications. Six platforms incorporated automated prompts via email, SMS, or push notifications to remind patients when assessments were due, and three added reminder systems for overdue questionnaires. Eight platforms described how data were presented to users, employing bar graphs, trend lines, raw scores, and traffic-light color coding to flag concerning results. Four platforms included clinician alerts triggered by severe or worsening symptoms, and seven provided tailored self-management advice based on individual responses. Notably, only two platforms were embedded within electronic medical records, with most operating as standalone systems requiring separate logins.

The review’s findings on acceptability and usability were broadly encouraging. In one study, 97 percent of patients with M-component dyscrasias scheduled for bortezomib treatment recommended the app, and 100 percent wished to continue logging side effects after the study ended. In a registry setting, 87.5 percent of multiple myeloma patients reported being quite to very satisfied with electronic monitoring, and no difference in acceptability was found between internet users and non-users. Clinicians were similarly positive, with 80 percent expressing satisfaction, and in one Italian study all hematologists agreed the CHES platform was easy to use, with 78 percent accessing it monthly to review patient data.

Feasibility and uptake, however, varied considerably. Completion rates ranged from 70.3 percent to 97 percent, with several studies reporting engagement above 80 percent even among acutely ill patients undergoing stem cell transplantation. Time burdens were generally manageable, with patients completing assessments in under six minutes on average in some studies, and clinicians needing roughly three minutes to review results after an initial 30-minute setup. Yet challenges emerged: one CHES study failed to meet its feasibility benchmark, largely attributed to COVID-19 disruptions, and another reported declining completion over time due to missed appointments and the absence of automated reminders, which were only added after the study concluded.

Perhaps most compelling are the downstream clinical outcomes. Patients using electronic symptom monitoring after stem cell transplantation experienced a significantly lower symptom burden, reporting 10.4 symptoms on average compared with 14.5 in controls. Medication adherence was strikingly high in one chronic myeloid leukemia study, with 92.5 percent of patients taking at least 90 percent of prescribed doses. Health-related quality of life improved or stabilized for 69 percent of transplant patients after discharge, and distress improved in multiple myeloma patients who received telehealth calls triggered by their symptom scores. Communication also benefited, with 78 percent of myeloma patients reporting that their care team was better informed.

Despite these gains, the review identified significant gaps. No platform included automatic referral mechanisms that would trigger supportive care services based on symptom severity, a notable omission given evidence that ePROMs can facilitate timely access to such care. Data on sustained use, long-term implementation, and costs were scarce, and few studies reported whether platforms persisted beyond the study period. The review also highlighted limited attention to culturally and linguistically diverse populations and to pediatric and caregiver populations, and noted that reporting on how customized questionnaires were developed was often insufficient to determine their validity.

The authors conclude that the diversity of platforms reflects the wide range of hematological diseases, treatments, and care settings in which ePROMs can be applied, underscoring their flexibility and adaptability. Future work, they argue, should focus on tailoring content to capture hematology-specific symptoms, optimizing the timing of assessments to align with clinical trajectories, and rigorously evaluating impacts on clinical outcomes and health service delivery. Design improvements such as adjustable font sizes, high-contrast interfaces, voice-assisted navigation, and onboarding tutorials could broaden accessibility for older patients and those with limited technological confidence. As digital health tools continue to proliferate across oncology, this review provides a roadmap for ensuring that the patient’s voice becomes a routine, actionable part of blood cancer care rather than an afterthought.

Subject of Research: Electronic patient-reported outcome platforms for symptom monitoring in hematological cancers

Article Title: Electronic patient-reported outcome platforms used in hematological cancers: a systematic review

Article References: Nikolovski, J., Franklin, M., Hawkes, E. A., Acret, L., Palmer, J., Serce, O., McQuilten, Z. K., Wood, E. M., & Rutherford, C. (2026). Electronic patient-reported outcome platforms used in hematological cancers: a systematic review. Supportive Care in Cancer, 34(10), Article 1018. https://doi.org/10.1007/s00520-026-11264-y

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11264-y

Keywords: ePROMs, hematological cancers, patient-reported outcomes, digital health, symptom monitoring, multiple myeloma, leukemia, quality of life, telehealth, systematic review, clinical care, mHealth