Objective Existing cross-sectional observational studies indicate that patients with multiple myeloma experience negative physical and psychological symptoms and low health-related quality of life. The study aim was to determine symptom prevalence, health-related quality of life and symptoms associated with health-related quality of life in patients with newly diagnosed multiple myeloma. Methods This multicenter longitudinal cohort study was conducted in four hospitals in Japan. Patients with newly diagnosed multiple myeloma were asked to report their symptom intensity and health-related quality of life using validated questionnaires at three points: at diagnosis (T1), 1 month (T2) and 12 months after diagnosis (T3). Symptoms associated with health-related quality of life were explored using a mixed-effects model. Results A total of 106 patients completed the assessment at T1. The symptoms more than 30% of patients reported were pain, disturbed sleep and distress at T1, pain, dry mouth, disturbed sleep and fatigue at T2, fatigue, numbness of tingling and pain and numbness or tingling at T3. Pain and depression were significantly associated with health-related quality of life negatively. Conclusions The finding suggests that more than 30% of multiple myeloma patients suffered from pain and various symptoms and they received suboptimal palliative care within a year after starting initial chemotherapy. Pain and depression should be the main targets of interventions to improve health-related quality of life in this population.

Cognitive decline may be involved in decreased health utility value in older adult patients with cancer. However, this effect does not seem to be independent, and the patient's physical condition may be a relevant confounding factor.

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Background: The quality of life (QOL) of family caregivers often deteriorates after the death of patients with terminal cancer. Although previous retrospective cross-sectional studies of the bereaved family caregivers of cancer patients have suggested that lower satisfaction with care given to terminal cancer patients was related to lower QOL of the bereaved family caregivers, the retrospective cross-sectional study design has limitations. Objectives: To clarify family caregivers' satisfaction with the care of terminal cancer patients and bereaved family caregivers' QOL. Design: A prospective pre-and postloss study. Setting/Subjects: Family caregivers of terminal cancer patients were recruited from three inpatient hospice/ palliative care units in Japan. Measurements: Family caregivers completed questionnaires, including the Family Satisfaction with Advanced Cancer Care (FAMCARE) scale before loss and the 36-item Short-Form Health Survey (SF-36) questionnaire before loss and six months after the patient's death. Results: A total of 114 family caregivers were included in each analysis. After the patient's death, bereaved family caregivers' mental component summary score of SF-36 significantly differed between low-and highsatisfaction caregiver groups (n = 47 in both groups, mean difference = 3.50, p = 0.048). The proportion of family caregivers with depressive symptoms (moderate or worse) at preloss was 41% (25/61) in the lowsatisfaction group and 22% (11/51) in the high-satisfaction group. Conclusions: Family caregivers' satisfaction with the care provided to terminal cancer patients at the end of their lives was associated with the bereaved family caregivers' QOL six months postloss. Enhancing family caregivers' satisfaction with care has the potential to improve their postloss QOL.

Objective The objective of the study is to investigate depressive symptoms before and after the initiation of chemotherapy and their impact on overall survival (OS) among patients with hematological malignancies. Methods We performed a prospective analysis of consecutive patients with newly diagnosed malignant lymphoma or multiple myeloma enrolled between September 2010 and March 2016. We evaluated depression symptoms at two time points: before starting chemotherapy (T1) and 1 month later (T2), using PHQ‐9 and known prognostic factors. We allocated participants with depressive symptoms at T1 and/or T2 to a depression group that was subdivided as follows: new depressive symptoms at T2, (“new‐onset”), remission of depressive symptoms at T2 (“remission”), and persistent depressive symptoms from T1 to T2 (“persistent”). The main outcome, OS, was evaluated using Kaplan‐Meier methods and multivariate Cox proportional hazards modeling. Results Of the 294 eligible participants, we analyzed 255 patients, including 83 with depression. There were 19 participants in the new‐onset, 38 in the remission, and 26 in the persistent depression group. The OS of participants with depression was significantly shorter than that of those without depression (adjusted hazard ratio [AjHR] 2.43; 95% confidence interval [CI] 1.43‐4.12; P < .001). Using the never‐depressive symptoms group as a reference group, AjHRs were as follows: new‐onset, 1.91 (95% CI, 0.77‐4.75; 0.166); remission, 2.98 (95% CI, 1.55‐5.74; 0.001), and persistent, 2.17 (95%CI, 1.01‐4.68; 0.047). Conclusions Among patients with mature lymphoid malignancy, the group with depression at baseline had a poorer survival, both in the group that remained depressive and the group that recovered from depressive symptoms.