TY - JOUR
T1 - Symptom burden and its functional impact in patients with “symptomatic” relapsed or refractory multiple myeloma
AU - Kamal, Mona
AU - Wang, Xin Shelley
AU - Shi, Qiuling
AU - Zyczynski, Teresa M.
AU - Davis, Catherine
AU - Williams, Loretta A.
AU - Lin, Hui Kai
AU - Garcia-Gonzalez, Araceli
AU - Cleeland, Charles S.
AU - Orlowski, Robert
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/1
Y1 - 2021/1
N2 - 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.
AB - 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.
KW - Functional outcomes
KW - Multiple myeloma
KW - Patient-reported outcomes
KW - Quality of life
KW - Refractory
KW - Symptom burden
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U2 - 10.1007/s00520-020-05493-y
DO - 10.1007/s00520-020-05493-y
M3 - Article
C2 - 32390093
AN - SCOPUS:85084366396
SN - 0941-4355
VL - 29
SP - 467
EP - 475
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 1
ER -