Financial toxicity in hematologic malignancies: from status and coping to humanistic care integration

Abstract: Recently, financial toxicity (FT) has emerged as a critical term in the field of comprehensive health research. It refers to the objective economic burden and subjective financial pressure experienced by patients and their families due to disease-related expenses and treatment costs. For patients with malignant hematological diseases (e.g., leukemia, lymphoma, multiple myeloma), the prolonged treatment cycle and high medical costs often result in significant FT, manifesting as substantial financial strain and diminished quality of life. Existing studies indicate that FT is prevalent among patients with malignant hematological diseases and is closely associated with treatment plan selection, out-of-pocket expenses, income levels, and healthcare security policies. Such toxicity can lead to treatment interruptions, heightened psychological stress, and reduced survival rates. Notably, most existing investigations merely describe the epidemiological characteristics and correlational relationships of FT across pan-cancer populations, while few conduct targeted critical analysis on the inherent defects of current research designs, intervention limitations and unmet clinical demands specific to hematologic malignancies. Furthermore, research gaps regarding FT management for patients receiving hematopoietic stem cell transplantation, CAR-T cell therapy and long-term maintenance treatment remain largely underexplored. However, while current research primarily focuses on assessment tools, influencing factors, and correlations with health outcomes, targeted interventions remain insufficient. This article systematically reviews the current research status of FT in patients with malignant hematological diseases, critically analyzes the flaws of existing studies, highlights unique FT-related dilemmas in hematologic malignancies, explores unresolved scientific questions and prospective research directions, aiming to explore precise intervention models and coping strategies to address FT and provide a reference framework for developing systematic solutions.