Matthias Naegele1,2, Monika Kirsch2,3, Gabriele Ihorst4,5, Katharina Fierz2, Monika Engelhardt1,5, Sabina De Geest6,7. 1. Department of Hematology/Oncology, University of Freiburg Medical Center, Freiburg, Germany. 2. Nursing Science, Faculty of Medicine, Department Public Health, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland. 3. Department of Hematology, University Hospital Basel, Basel, Switzerland. 4. Clinical Trials Unit, University of Freiburg, Freiburg, Germany. 5. Faculty of Medicine, University of Freiburg, Freiburg, Germany. 6. Nursing Science, Faculty of Medicine, Department Public Health, University of Basel, Bernoullistrasse 28, CH-4056, Basel, Switzerland. Sabina.degeest@unibas.ch. 7. Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium. Sabina.degeest@unibas.ch.
Abstract
PURPOSE: High-dose melphalan and autologous stem cell transplantation (ASCT) are associated with high symptom burden. This study aimed to explore multiple myeloma (MM) patients' experience of symptom frequency, intensity, and distress during therapy. METHODS: This descriptive longitudinal study enrolled 29 MM patients who completed the 43-item PROVIVO questionnaire, measuring symptom experience across the dimensions of frequency, intensity, and distress at four assessment points: hospital admission (T0), leucocyte nadir (T1), discharge (T2), and 30 days post discharge (T3). Symptom assessment covered five categories: (1) physical, (2) emotional, (3) cognitive, (4) male/female urogenital symptoms, and (5) follow-up care planning (e.g., financial problems). Results were displayed as heat maps and bubble graphs for each patient, differences between T0 and T4 individually assessed, and intensity (IMS) and mean distress scores (DMS) calculated on a scale from 0 to 4. RESULTS: The most frequent, intense, and distressing physical symptoms were fatigue, diarrhea, and decreased appetite. As expected, peak symptom intensity (decreased appetite 2.79) and distress (diarrhea 2.11) were reported during high-dose melphalan and the leucocyte nadir (T1). Thereafter, most symptoms' intensity and distress improved. Items on urogenital symptoms remained predominantly unanswered or patients were sexually inactive. CONCLUSIONS: PROVIVO enabled exploration of various dimensions of MM patients' symptom experiences, which differed substantially before and after ASCT. Our results suggest that high-dose melphalan, ASCT, and other intensive novel agent therapies warrant targeted symptom management programs that include focused patient support.
PURPOSE: High-dose melphalan and autologous stem cell transplantation (ASCT) are associated with high symptom burden. This study aimed to explore multiple myeloma (MM) patients' experience of symptom frequency, intensity, and distress during therapy. METHODS: This descriptive longitudinal study enrolled 29 MMpatients who completed the 43-item PROVIVO questionnaire, measuring symptom experience across the dimensions of frequency, intensity, and distress at four assessment points: hospital admission (T0), leucocyte nadir (T1), discharge (T2), and 30 days post discharge (T3). Symptom assessment covered five categories: (1) physical, (2) emotional, (3) cognitive, (4) male/female urogenital symptoms, and (5) follow-up care planning (e.g., financial problems). Results were displayed as heat maps and bubble graphs for each patient, differences between T0 and T4 individually assessed, and intensity (IMS) and mean distress scores (DMS) calculated on a scale from 0 to 4. RESULTS: The most frequent, intense, and distressing physical symptoms were fatigue, diarrhea, and decreased appetite. As expected, peak symptom intensity (decreased appetite 2.79) and distress (diarrhea 2.11) were reported during high-dose melphalan and the leucocyte nadir (T1). Thereafter, most symptoms' intensity and distress improved. Items on urogenital symptoms remained predominantly unanswered or patients were sexually inactive. CONCLUSIONS: PROVIVO enabled exploration of various dimensions of MMpatients' symptom experiences, which differed substantially before and after ASCT. Our results suggest that high-dose melphalan, ASCT, and other intensive novel agent therapies warrant targeted symptom management programs that include focused patient support.
Authors: Philip R Greipp; Jesus San Miguel; Brian G M Durie; John J Crowley; Bart Barlogie; Joan Bladé; Mario Boccadoro; J Anthony Child; Herve Avet-Loiseau; Jean-Luc Harousseau; Robert A Kyle; Juan J Lahuerta; Heinz Ludwig; Gareth Morgan; Raymond Powles; Kazuyuki Shimizu; Chaim Shustik; Pieter Sonneveld; Patrizia Tosi; Ingemar Turesson; Jan Westin Journal: J Clin Oncol Date: 2005-04-04 Impact factor: 44.544
Authors: Douglas E Peterson; Kerstin Ohrn; Joanne Bowen; Monica Fliedner; Judith Lees; Charles Loprinzi; Takehiko Mori; Anthony Osaguona; Dianna S Weikel; Sharon Elad; Rajesh V Lalla Journal: Support Care Cancer Date: 2012-09-21 Impact factor: 3.603
Authors: M Díez-Campelo; J A Pérez-Simón; J R González-Porras; J M García-Cecilia; M Salinero; M D Caballero; M C Cañizo; E M Ocio; J F San Miguel Journal: Bone Marrow Transplant Date: 2004-10 Impact factor: 5.483
Authors: Ethan Basch; Alexia Iasonos; Allison Barz; Ann Culkin; Mark G Kris; David Artz; Paul Fearn; John Speakman; Rena Farquhar; Howard I Scher; Mary McCabe; Deborah Schrag Journal: J Clin Oncol Date: 2007-12-01 Impact factor: 44.544
Authors: Erica Campagnaro; Rima Saliba; Sergio Giralt; Linda Roden; Floralyn Mendoza; Ana Aleman; Charles Cleeland; Donna Weber; Jane Brown; Karen O Anderson Journal: Cancer Date: 2008-04-01 Impact factor: 6.860
Authors: Rachel Cusatis; Joanna Balza; Zachary Uttke; Vishwajit Kode; Elizabeth Suelzer; Bronwen E Shaw; Kathryn E Flynn Journal: Qual Life Res Date: 2022-10-06 Impact factor: 3.440
Authors: Rahul Banerjee; Chiung-Yu Huang; Lisa Dunn; Jennifer Knoche; Chloe Ryan; Kelly Brassil; Lindsey Jackson; Dhiren Patel; Mimi Lo; Shagun Arora; Sandy W Wong; Jeffrey Wolf; Thomas Martin Iii; Anand Dhruva; Nina Shah Journal: JMIR Form Res Date: 2022-03-04