Mona Kamal1,2, Xin Shelley Wang3, Qiuling Shi1, Teresa M Zyczynski4, Catherine Davis4, Loretta A Williams1, Hui-Kai Lin1, Araceli Garcia-Gonzalez1, Charles S Cleeland1, Robert Orlowski5. 1. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 2. Department of Clincal Oncology, Ain Shams University, Cairo, Egypt. 3. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. xswang@mdanderson.org. 4. Bristol-Myers Squibb, Princeton, NJ, USA. 5. Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Abstract
PURPOSE: Relapsed or refractory multiple myeloma (RRMM) is labeled "symptomatic" based on laboratory values, but not relevant to quantitative measure of patient's perspectives. This study aimed to describe symptom burden, health status, and quality of life in RRMM patients. METHODS: The cross-sectional study included 184 MM patients (141 RRMM cases and 43 MM patients on follow-up without diagnosis/treatment of RRMM disease as controls), while 64 RRMM patients also provided longitudinal patient-reported outcomes (PROs) data. Symptomatic status was based on clinical measures of disease activity. PROs included the MD Anderson Symptom Inventory multiple myeloma module (MDASI-MM), single-item quality of life (SIQOL), and EuroQol-5D (EQ-5D). Wilcoxon rank test and effect size were used for comparisons. Regression models were used to describe symptom trajectory and to identify predictors of high symptom burden during 3 months of RRMM therapy. RESULTS: Most patients were clinically identified as symptomatic (93%). RRMM patients tended to report more severe symptoms, with significantly lower QOL scores and more severe fatigue, poor appetite, and lower enjoyment of life compared with controls (all p < 0.05). In RRMM patients, lower hemoglobin and higher B-2 microglobulin levels significantly correlated with higher burdens of fatigue, pain, and muscle weakness and also with lower QOL and EQ-5D scores (all p < 0.05). During RRMM therapy, being female, with any comorbidity, ≥ 65 years old, and ≥ 5 years MM history, contributed to high symptoms burden and poor QOL status (each p < 0.05). CONCLUSIONS: MDASI-MM modules were sensitive to detect the RRMM-related symptoms burden, which correlated with objective clinical measures. RRMM patients reported a more compromised QOL.
PURPOSE: Relapsed or refractory multiple myeloma (RRMM) is labeled "symptomatic" based on laboratory values, but not relevant to quantitative measure of patient's perspectives. This study aimed to describe symptom burden, health status, and quality of life in RRMM patients. METHODS: The cross-sectional study included 184 MM patients (141 RRMM cases and 43 MM patients on follow-up without diagnosis/treatment of RRMM disease as controls), while 64 RRMM patients also provided longitudinal patient-reported outcomes (PROs) data. Symptomatic status was based on clinical measures of disease activity. PROs included the MD Anderson Symptom Inventory multiple myeloma module (MDASI-MM), single-item quality of life (SIQOL), and EuroQol-5D (EQ-5D). Wilcoxon rank test and effect size were used for comparisons. Regression models were used to describe symptom trajectory and to identify predictors of high symptom burden during 3 months of RRMM therapy. RESULTS: Most patients were clinically identified as symptomatic (93%). RRMM patients tended to report more severe symptoms, with significantly lower QOL scores and more severe fatigue, poor appetite, and lower enjoyment of life compared with controls (all p < 0.05). In RRMM patients, lower hemoglobin and higher B-2 microglobulin levels significantly correlated with higher burdens of fatigue, pain, and muscle weakness and also with lower QOL and EQ-5D scores (all p < 0.05). During RRMM therapy, being female, with any comorbidity, ≥ 65 years old, and ≥ 5 years MM history, contributed to high symptoms burden and poor QOL status (each p < 0.05). CONCLUSIONS: MDASI-MM modules were sensitive to detect the RRMM-related symptoms burden, which correlated with objective clinical measures. RRMM patients reported a more compromised QOL.
Authors: Francesco Sparano; Michele Cavo; Pasquale Niscola; Tommaso Caravita; Fabio Efficace Journal: Support Care Cancer Date: 2018-03-20 Impact factor: 3.603
Authors: David S Siegel; Meletios A Dimopoulos; Heinz Ludwig; Thierry Facon; Hartmut Goldschmidt; Andrzej Jakubowiak; Jesus San-Miguel; Mihaela Obreja; Julie Blaedel; A Keith Stewart Journal: J Clin Oncol Date: 2018-01-17 Impact factor: 44.544
Authors: Desiree Jones; Elisabeth G Vichaya; Xin Shelley Wang; Loretta A Williams; Nina D Shah; Sheeba K Thomas; Valen E Johnson; Richard E Champlin; Charles S Cleeland; Tito R Mendoza Journal: J Hematol Oncol Date: 2013-02-05 Impact factor: 17.388