Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: results of a European, multicenter cohort study

Abstract

PurposeNovel multiple myeloma (MM) therapies have increased patient longevity but are often associated with notable symptom burden. This study quantified the effect of general symptom level, specific symptoms, and treatment-related adverse events (AEs) on MM patients’ health-related quality of life (HRQoL).MethodsThe European Organization for Research and Treatment of Cancer (EORTC) generic cancer questionnaire (Quality of Life Questionnaire Core 30) and MM-specific questionnaire (QLQ-MY20) were used in this study to assess patients’ HRQoL. Data were collected on sociodemographics, disease and treatment history, and the presence/severity of MM-related symptoms or treatment-related AEs from patients with MM in 11 UK and German centers. Multiple regression analyses were conducted.ResultsOf 154 patients (63 % male; mean age, 66.4 years; mean time since diagnosis, 3.7 years; 52 % currently on treatment; and 43 % with ≥1 prior MM therapy), 25, 32, 31, and 11 % were severely symptomatic, moderately symptomatic, mildly symptomatic, and asymptomatic, respectively. Fatigue (59 %), bone pain (51 %), sleepiness (36 %), hypoesthesia or paresthesia (33 %), and muscle cramps (31 %) were most commonly reported. Moderate and severe general symptom levels, bone symptoms, depression, and mental status changes were identified as strong determinants of HRQoL.ConclusionsSeverity, type of disease symptoms, and treatment-related AEs are important HRQoL determinants in patients with MM, allowing for targeted treatment.

Pomalidomide and Low-Dose Dexamethasone Improves Health-Related Quality of Life and Prolongs Time to Worsening in Relapsed/Refractory Patients With Multiple Myeloma Enrolled in the MM-003 Randomized Phase III Trial

“…HRQoL decreases as burden of illness increases over time with progression of disease. 1,2 Patients often complain of fatigue and pain, 3,4 and frequently show symptoms of emotional distress, such as anxiety and depression. Impairment in physical and emotional functioning is well described in these patients.…”

The effects of proteasome inhibitors on bone remodeling in multiple myeloma

“…The occurrence of SREs has been linked to inferior survival [5,6], reduced quality of life [7], and increased healthcare costs for patients with MM [8,9]. …”

Long-term health-related quality of life in transplant-ineligible patients with newly diagnosed multiple myeloma receiving lenalidomide and dexamethasone

“…Symptoms of fatigue and pain are interrelated, as pain decreases physical activity and negatively affects performance status, mood and sleep, resulting in increased fatigue [25]. A cohort study and cross-sectional analysis of patients with MM reported that disease duration, symptom burden, bone symptoms, and being currently on therapy were strong predictors of global health status on multiple regression analyses [26]. Anemia also has a known adverse impact on physical functioning and QoL variables including fatigue [27], which can drive patients to abandon treatment [28]; it also leads to other symptoms that adversely affect patients' physical status, functional capacity, and overall QoL [29].…”