Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life

Osborne, Thomas R.; Ramsenthaler, Christina; Wolf-Linder, Susanne de; Schey, Stephen; Siegert, Richard J.; Edmonds, Polly; Higginson, Irene J

doi:10.1186/1471-2407-14-496

Cited by 71 publications

(104 citation statements)

References 39 publications

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“…28 This finding should also be considered in the context of the limitations of existing instruments. 29,30 The rates of serious adverse events, discontinuation of the study regimen because of adverse events, and death during the study period were similar in the two groups, and the only adverse event of grade 3 or higher for which there was at least a 5% difference between the ixazomib and placebo groups was thrombocytopenia, a known side effect of bortezomib and carfilzomib, 31,32 for which there were no apparent clinical sequelae. No cardiac, renal, or respiratory safety signals were associated with the use of ixazomib.…”

Section: Discussionmentioning

confidence: 90%

Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma

et al. 2016

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BACKGROUNDIxazomib is an oral proteasome inhibitor that is currently being studied for the treatment of multiple myeloma. METHODSIn this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 722 patients who had relapsed, refractory, or relapsed and refractory multiple myeloma to receive ixazomib plus lenalidomide-dexamethasone (ixazomib group) or placebo plus lenalidomidedexamethasone (placebo group). The primary end point was progression-free survival. RESULTSProgression-free survival was significantly longer in the ixazomib group than in the placebo group at a median follow-up of 14.7 months (median progression-free survival, 20.6 months vs. 14.7 months; hazard ratio for disease progression or death in the ixazomib group, 0.74; P = 0.01); a benefit with respect to progression-free survival was observed with the ixazomib regimen, as compared with the placebo regimen, in all prespecified patient subgroups, including in patients with high-risk cytogenetic abnormalities. The overall rates of response were 78% in the ixazomib group and 72% in the placebo group, and the corresponding rates of complete response plus very good partial response were 48% and 39%. The median time to response was 1.1 months in the ixazomib group and 1.9 months in the placebo group, and the corresponding median duration of response was 20.5 months and 15.0 months. At a median follow-up of approximately 23 months, the median overall survival has not been reached in either study group, and follow-up is ongoing. The rates of serious adverse events were similar in the two study groups (47% in the ixazomib group and 49% in the placebo group), as were the rates of death during the study period (4% and 6%, respectively); adverse events of at least grade 3 severity occurred in 74% and 69% of the patients, respectively. Thrombocytopenia of grade 3 and grade 4 severity occurred more frequently in the ixazomib group (12% and 7% of the patients, respectively) than in the placebo group (5% and 4% of the patients, respectively). Rash occurred more frequently in the ixazomib group than in the placebo group (36% vs. 23% of the patients), as did gastrointestinal adverse events, which were predominantly low grade. The incidence of peripheral neuropathy was 27% in the ixazomib group and 22% in the placebo group (grade 3 events occurred in 2% of the patients in each study group). Patient-reported quality of life was similar in the two study groups. CONCLUSIONSThe addition of ixazomib to a regimen of lenalidomide and dexamethasone was associated with significantly longer progression-free survival; the additional toxic effects with this all-oral regimen were limited. (Funded by Millennium Pharmaceuticals; TOURMALINE-MM1 ClinicalTrials.gov number, NCT01564537.)

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Section: Discussionmentioning

confidence: 90%

Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma

et al. 2016

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“…[35][36][37] It can also promote the reduction of stress and positively influence the patient's perceived independence. 22 Effects of rehabilitation related to the psychosocial sphere, such as anxiety, stress and depression, were also found, as well as the patients' desire to feel physically better, even when they know that death is approaching.…”

Section: Discussionmentioning

confidence: 99%

“…One of these dimensions is activity and participation. 37 The rehabilitation offers many potential contributions to improvements in this domain. Nevertheless, to enhance the probability of success, the health professional needs to take into account the patients' limitations and change the program whenever necessary.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation in Palliative Care

Minosso

Souza²,

Oliveira³

2016

Texto contexto - enferm.

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abstRaCt:The objective of this study was to describe the activities and effects of functional rehabilitation in patients receiving palliative care. It is an integrative review, in which LILACS, BDENF, Coleciona SUS (Brazil) and PUBMED were used, 20 articles were selected, subsequently characterized as having designs of medium and low impact, more than half ranked with evidence levels II, III and IV and with samples not always consistent with the research designs. However, the results revealed the potential of rehabilitation to improve the functional status, quality of life and symptoms like pain and anxiety in this population, through interventions that are many times undervalued in palliative care. The conclusion is that rehabilitation is a feasible strategy to combat functional decline and improve the quality of life of patients in palliative care.DesCRiPtoRs: Palliative care. Activities of daily living. Rehabilitation. ReabilitaÇÃo eM CUiDaDos PaliativosResUMo: O objetivo deste estudo foi descrever as atividades e os efeitos da reabilitação funcional em pacientes que recebem cuidados paliativos. Trata-se de uma revisão integrativa que utilizou as bases de dados LILACS, BDENF, Coleciona SUS (Brasil) e PubMed. Foram selecionados 20 artigos, posteriormente caracterizados como de desenhos de médio e baixo impacto, sendo que mais da metade foi classificada com níveis de evidência II, III e IV e amostras nem sempre condizentes com os desenhos de pesquisa. Porém, os resultados revelaram o potencial da reabilitação para melhoria do estado funcional, da qualidade de vida e sintomas como dor e ansiedade nessa população, por meio de intervenções muitas vezes subvalorizadas em cuidados paliativos. Conclui-se que a reabilitação é uma estratégia viável para combater o declínio funcional e melhorar a qualidade de vida de pacientes em cuidados paliativos.DesCRitoRes: Cuidados paliativos. Atividades cotidianas. Reabilitação. ReHabilitaCiÓn en CUiDaDos PaliativosResUMen: El objetivo de este estudio fue describir las actividades y los efectos de la rehabilitación funcional en pacientes que reciben cuidados paliativos. Es una revisión integradora que utiliza las bases de datos LILACS, BDENF, Coleciona SUS (Brasil) y PUBMED. Se seleccionaron 20 artículos, después caracterizados con diseños de mediano y bajo impacto, y más de la mitad se clasificó con niveles de evidencia II, III, IV y con muestras no siempre consistentes con los diseños de investigación. Todavía, los resultados revelaran el potencial de la rehabilitación para mejorar el estado funcional, la calidad de vida y los síntomas como dolor y ansiedad en esta población, a través de intervenciones muchas veces infravaloradas en cuidados paliativos. Se concluye que la rehabilitación es una estrategia viable para combatir el deterioro funcional y mejorar la calidad de vida de los pacientes en cuidados paliativos.DesCRiPtoRes: Cuidados paliativos. Actividades cotidianas. Rehabilitación.

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“…High-dose corticosteroids may exacerbate anxiety and insomnia. 28 Financial burden of therapy is another important consideration; some treatments may present a significant burden 29 , and the cost and burden of informal caregiving must be considered as well. 30 Almost half of partners of people living with multiple myeloma report significant anxiety, and one-third report unmet tangible, emotional and information needs.…”

Section: Geriatric Assessmentmentioning

confidence: 99%

Management of multiple myeloma in older adults: Gaining ground with geriatric assessment

Wildes

Campagnaro

2017

Journal of Geriatric Oncology

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Multiple myeloma increases in incidence with age. With the aging of the population, the number of cases of multiple myeloma diagnosed in older adults each year will nearly double in the next 20 years. The novel therapeutic agents have significantly improved survival in older adults, but their outcomes remain poorer than in younger patients. Older adults may be more vulnerable to toxicity of therapy, resulting in decreased dose intensity and contributing to poorer outcomes. Data are beginning to emerge to aid in identifying which individuals are at greater risk for toxicity of therapy; comorbidities, functional limitations and age over 80 are among the factors associated with greater risk. Geriatric assessment holds promise in the care of older adults with multiple myeloma, both to allow modification of treatment to prevent toxicity, and to identify vulnerabilities that may require intervention. Emerging treatments with low toxicity and attention to individualizing therapy based on geriatric assessment may aid in further improving outcomes in older adults with multiple myeloma.

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Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life

Cited by 71 publications

References 39 publications

Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma

Oral Ixazomib, Lenalidomide, and Dexamethasone for Multiple Myeloma

Rehabilitation in Palliative Care

Management of multiple myeloma in older adults: Gaining ground with geriatric assessment

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