A latent profile analysis of financial toxicity and its association with anxiety and depression in patients with hematologic malignancies

Objective: To identify latent subgroups of financial toxicity among patients with hematologic malignancies, examine associated sociodemographic and clinical predictors, and explore the relationship between financial toxicity and anxiety-depression symptoms. Methods: A cross-sectional study was conducted among 486 patients with hematologic malignancies recruited through convenience sampling from provincial-level hospitals in Hunan Province, China. Participants completed the General Information Questionnaire, the Patient-Reported Outcome Financial Toxicity (PRO-FT) Scale, the Patient Health Questionnaire-4 (PHQ-4), and the Perceived Social Support Scale (PSSS). Latent profile analysis (LPA) was used to identify subgroups of financial toxicity. Multinomial logistic regression was employed to explore influencing factors, and Kruskal-Wallis tests were used to compare anxiety and depression levels across the identified subgroups. Results: Three distinct profiles of financial toxicity were identified: "No financial toxicity" (13.99%), "Mild financial toxicity" (38.68%), and "Moderate financial toxicity" (47.33%). Compared with the no-toxicity profile, predictors of being in the mild or moderate toxicity profiles included sex, marital status, occupation, residence, family monthly income, treatment stage, insurance, and social support. When the mild toxicity profile was used as the reference, progression to the moderate profile was further associated with residence, family monthly income, diagnosis, chronic disease, course of disease, insurance, and social support. Higher levels of financial toxicity were significantly associated with increased anxiety and depression scores. Conclusions: Financial toxicity among patients with hematologic malignancies is heterogeneous and closely linked to sociodemographic and clinical characteristics. Moreover, increased financial toxicity is associated with elevated psychological distress. Target interventions addressing financial strain and enhancing psychological support are essential to improve patient outcomes.