Quality of life in multiple myeloma: considerations and recommendations.

Introduction: Advances in the management of multiple myeloma have culminated in the availability of novel agents which have resulted in improvement in patient outcomes. Nevertheless, the disease remains largely incurable and attention to long-term toxicity and quality of life is of importance. Limited data have addressed quality-of-life consideration in myeloma and most studies have assessed a finite time period during the course of the disease. Quality-of-life measures that have been used have largely focused on symptom reporting. In general, quality of life seems to deteriorate with increasing duration of the disease and improvements are limited. Areas covered: This manuscript will review quality-of-life tools used in myeloma as well as the differential effect of various stages of the therapy. Expert opinion: In general, depth of response has been associated with improved quality-of-life and may be an important surrogate provided that therapy is well tolerated. However, this traditional approach of using the most effective therapy does not take into considerations psychologic and socioeconomic factors which can result in significant burden to the patient. A multidisciplinary team approach with a focus on shared decision-making based on the patient's goals must thus be emphasized.