Health-related quality of life of multiple myeloma patients after the first-line treatment: results of a prospective cohort study
DOI:
https://doi.org/10.33448/rsd-v11i12.34709Keywords:
Multiple Myeloma; Quality of life; Thalidomide; Bortezomib; Peripheral neuropathy.Abstract
Objective: The aim of this study was to evaluate whether there was an improvement or a deterioration of health-related quality of life (HRQoL) of multiple myeloma patients (MM), and to assess the associated factors with HRQoL after 12 months of treatment. Methods: We performed a prospective cohort study with MM patients in first-line treatment from public and private onco-hematology health services in a Brazilian metropolis. HRQoL, socio-demographic and clinical variables were obtained by interviews and review of medical charts. HRQoL and peripheral neuropathy (PN) were collected through validated instruments (QLQ-C30, QLQ-MY20, CINQ). Medians of the HRQoL scores, obtained at baseline and follow-up interviews, were compared. Median HRQOL scores at follow-up were compared by variables. The improvement or deterioration in HRQoL and the association with variables were measured. Results: Thirty-three patients completed the follow-up, with ISS III (25.0 %), on polypharmacy (72.2 %), using a thalidomide+bortezomib-based regimen as first-line (19.4 %), and median age of 66.5 years. HRQoL Summary score, Functioning, Symptom scales, and Future Perspective scores were improved between periods (p<0.05). Patients who were on polypharmacy, with severe PN, and with ISS III had deterioration in HRQoL; younger patients had improvement and older patients had deterioration in HRQoL (p<0.05). Conclusions: Our study showed that first-line treatment improved HRQoL of patients in the following QLQ-C30 scales: Summary score, Role functioning, Emotional functioning, Fatigue, Pain, and Constipation; and in QLQ-MY20, Future perspective was improved. Our study shows the importance of using patient-reported outcomes during MM treatment.
References
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., Filiberti, A., Flechtner, H., Fleishman, S. B., de Haes, J. C. J. M., Kaasa, S., Klee, M., Osoba, D., Razavi, D., Rofe, P. B., Schraub, S., Sneeuw, K., Sullivan, M., & Takeda, F. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L23073154
Beijers, A. J. M., Vreugdenhil, G., Oerlemans, S., Eurelings, M., Minnema, M. C., Eeltink, C. M., van de Poll-Franse, L. V., & Mols, F. (2016). Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice. Supportive Care in Cancer, 24(6), 2411–2420. https://doi.org/10.1007/s00520-015-3032-y
Bendel, R. B., & Afifi, A. A. (1977). Comparison of Stopping Rules in Forward “Stepwise” Regression. Journal of the American Statistical Association, 72(357), 46. https://doi.org/10.2307/2286904
Brasil. (2015). Ministério da Saúde. Secretaria de Atenção à Saúde. Portaria no 708, de 6 de agosto. Aprova as Diretrizes Diagnósticas e Terapêuticas do Mieloma Múltiplo. DOU 07/08/2015. (p. 38).
Celentano, D. D., Szklo, M., & Gordis, L. (2019). Gordis epidemiology (6th ed.). Elsevier.
Cocks, K., Cohen, D., Wisløff, F., Sezer, O., Lee, S., Hippe, E., Gimsing, P., Turesson, I., Hajek, R., Smith, A., Graham, L., Phillips, A., Stead, M., Velikova, G., & Brown, J. (2007). An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-MY20) in assessing the quality of life of patients with multiple myeloma. European Journal of Cancer, 43(11), 1670–1678. https://doi.org/10.1016/j.ejca.2007.04.022
Etto, L. Y., Morelli, V. M., Silva, V. C., Hungria, V. T. M., Ciconelli, R. M., Almeida, M. S. S., Oliveira, J. S. R. de, Barros, J. C., Durie, B. G., & Colleoni, G. W. B. (2011). Autologous stem cell transplantation improves quality of life in economically challenged, Brazilian multiple myeloma patients. Clinics (Sao Paulo, Brazil), 66(11), 1855–1859. https://doi.org/10.1590/s1807-59322011001100002
Fayers, P., Aaronson, N., Bjordal, K., Groenvold, M., Curran, D., & Bottomley, A. (2001). The EORTC QLQ-C30 Scoring Manual (3rd Edition). European Organisation for Research and Treatment of Cancer.
Fortin, M., Lapointe, L., Hudon, C., Vanasse, A., Ntetu, A. L., & Maltais, D. (2004). Multimorbidity and quality of life in primary care: a systematic review. Health and Quality of Life Outcomes, 2(1), 51. https://doi.org/10.1186/1477-7525-2-51
Giesinger, J. M., Kieffer, J. M., Fayers, P. M., Groenvold, M., Petersen, M. A., Scott, N. W., Sprangers, M. A. G., Velikova, G., & Aaronson, N. K. (2016). Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust. Journal of Clinical Epidemiology, 69, 79–88. https://doi.org/https://doi.org/10.1016/j.jclinepi.2015.08.007
Greipp, P. R., Miguel, J. S., Dune, B. G. M., Crowley, J. J., Barlogie, B., Bladé, J., Boccadoro, M., Child, J. A., Harousseau, J. L., Kyle, R. A., Lahuerta, J. J., Ludwig, H., Morgan, G., Powles, R., Shimizu, K., Shustik, C., Sonneveld, P., Tosi, P., Turesson, I., & Westin, J. (2005). International staging system for multiple myeloma. Journal of Clinical Oncology, 23(15), 3412–3420. https://doi.org/10.1200/JCO.2005.04.242
Hungria, V. T. M., Maiolino, A., Martinez, G., Colleoni, G. W. B., Coelho, É. O. D. M., Rocha, L., Nunes, R., Bittencourt, R., Oliveira, L. C. O., Faria, R. M. O., Pasquini, R., Magalhães, S. M. M., Souza, C. A., Pinto Neto, J. V., Barreto, L., Andrade, E., Portella, M. D. S. O., Bolejack, V., & Durie, B. G. M. (2008). Confirmation of the utility of the International Staging System and identification of a unique pattern of disease in Brazilian patients with multiple myeloma. Haematologica, 93(5), 791–792. https://doi.org/10.3324/haematol.11637
Institute for Health Metrics and Evaluation (IHME). (2015). GBD Compare. Seattle, WA: IHME, University of Washington. http://vizhub.healthdata.org/gbd-compare.
Kang, H.-Y., & Choi, E.-Y. (2019). Factors influencing quality of life in patients with multiple myeloma. Contemporary Nurse, 55(2–3), 109–121. https://doi.org/10.1080/10376178.2019.1623699
Kerckhove, N., Collin, A., Condé, S., Chaleteix, C., Pezet, D., Balayssac, D., & Guastella, V. (2018). Chemotherapy-induced peripheral neuropathy: Symptomatology and epidemiology. Bulletin Du Cancer, 105(11), 1020–1032. https://doi.org/10.1016/j.bulcan.2018.07.009
Koeppen, S. (2014). Treatment of multiple myeloma: Thalidomide-, bortezomib-, and lenalidomide-induced peripheral neuropathy. Oncology Research and Treatment, 37(9), 506–513. https://doi.org/10.1159/000365534
Kumar, S. K., Dispenzieri, A., Lacy, M. Q., Gertz, M. A., Buadi, F. K., Pandey, S., Kapoor, P., Dingli, D., Hayman, S. R., & Leung, N., Lus, J. (2014). Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients. Leukemia, 28(5), 1122–1128. https://doi.org/10.1038/leu.2013.313.Continued
Kyle, R. A., Gertz, M. A., Witzig, T. E., Lust, J. A., Lacy, M. Q., Dispenzieri, A., Fonseca, R., Rajkumar, S. V., Offord, J. R., Larson, D. R., Plevak, M. E., Therneau, T. M., & Greipp, P. R. (2003). Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proceedings, 78(1), 21–33. https://doi.org/10.4065/78.1.21
Leonard, G. D., Wright, M. A., Quinn, M. G., Fioravanti, S., Harold, N., Schuler, B., Thomas, R. R., & Grem, J. L. (2005). Survey of oxaliplatin-associated neurotoxicity using an interview-based questionnaire in patients with metastatic colorectal cancer. BMC Cancer, 5, 1–10. https://doi.org/10.1186/1471-2407-5-116
Lu, S. X. (2020). Modern treatments and future directions for newly diagnosed multiple myeloma patients. Best Practice & Research Clinical Haematology, 33(1), 101151. https://doi.org/https://doi.org/10.1016/j.beha.2020.101151
Ludwig, H., Moreau, P., Dimopoulos, M. A., Mateos, M.-V., Kaiser, M., Hajek, R., Feng, S., Cocks, K., Buchanan, J., & Weisel, K. (2019). Health-related quality of life in the ENDEAVOR study: carfilzomib-dexamethasone vs bortezomib-dexamethasone in relapsed/refractory multiple myeloma. Blood Cancer Journal, 9(3), 23. https://doi.org/10.1038/s41408-019-0181-0
Malta, J. S., Drummond, P. L. de M., Silveira, L. P., Costa, N. L., Santos, R. M. M. dos, Machado, C. J., Reis, A. M. M., & de Pádua, C. A. M. (2022). Effect of therapeutic regimens and polypharmacy on health-related quality of life of people with multiple myeloma: a cross-sectional study in Belo Horizonte, Brazil. Current Medical Research and Opinion, 1–22. https://doi.org/10.1080/03007995.2022.2034387
Malta, J. S., Silveira, L. P., Drummond, P. L. de M., Costa, N. L., dos Santos, R. M. M., Reis, I. A., Reis, A. M. M., & de Pádua, C. A. M. (2021). Validity and reliability of the QLQ-MY20 module for assessing the health-related quality of life in Brazilians with multiple myeloma. Current Medical Research and Opinion, 0(0), 1–14. https://doi.org/10.1080/03007995.2021.1929136
Mols, F., Beijers, T., Vreugdenhil, G., & Van De Poll-Franse, L. (2014). Chemotherapy-induced peripheral neuropathy and its association with quality of life: A systematic review. Supportive Care in Cancer, 22(8), 2261–2269. https://doi.org/10.1007/s00520-014-2255-7
National Cancer Institute. (2017). Common Terminology Criteria for Adverse Events (CTCAE) v5.0. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf
Nielsen, L. K., Jarden, M., Andersen, C. L., Frederiksen, H., & Abildgaard, N. (2017). A systematic review of health-related quality of life in longitudinal studies of myeloma patients. European Journal of Haematology, 99(1), 3–17. https://doi.org/10.1111/ejh.12882
Paiva, C. E., Carneseca, E. C., Barroso, E. M., de Camargos, M. G., Alfano, A. C. C., Rugno, F. C., & Paiva, B. S. R. (2014). Further evaluation of the EORTC QLQ-C30 psychometric properties in a large Brazilian cancer patient cohort as a function of their educational status. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 22(8), 2151–2160. https://doi.org/10.1007/s00520-014-2206-3
Palumbo, A., & Anderson, K. (2011). Medical Progress Multiple Myeloma. N Engl J Med.
Pessoa de Magalhães Filho, R. J., Crusoe, E., Riva, E., Bujan, W., Conte, G., Navarro Cabrera, J. R., Garcia, D. K., Vega, G. Q., Macias, J., Oliveros Alvear, J. W., Royg, M., Neves, L. A., Lopez Dopico, J. L., Espino, G., Ortiz, D. R., Socarra, Z., Fantl, D., Ruiz-Arguelles, G. J., Maiolino, A., … Durie, B. (2019). Analysis of Availability and Access of Anti-myeloma Drugs and Impact on the Management of Multiple Myeloma in Latin American Countries. Clinical Lymphoma, Myeloma and Leukemia, 19(1), e43–e50. https://doi.org/10.1016/j.clml.2018.08.005
Plesner, T., Dimopoulos, M. A., Oriol, A., San-Miguel, J., Bahlis, N. J., Rabin, N., Suzuki, K., Yoon, S.-S., Ben-Yehuda, D., Cook, G., Goldschmidt, H., Grosicki, S., Qin, X., Fastenau, J., Garvin, W., Carson, R., Renaud, T., & Gries, K. S. (2021). Health-related quality of life in patients with relapsed or refractory multiple myeloma: treatment with daratumumab, lenalidomide, and dexamethasone in the phase 3 POLLUX trial. British Journal of Haematology, 194(1), 132–139. https://doi.org/10.1111/bjh.17435
Rajkumar, S. V. (2020). Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. American Journal of Hematology, 95(5), 548–567. https://doi.org/10.1002/ajh.25791
Ramsenthaler, C., Osborne, T. R., Gao, W., Siegert, R. J., Edmonds, P. M., Schey, S. A., & Higginson, I. J. (2016). The impact of disease-related symptoms and palliative care concerns on health-related quality of life in multiple myeloma: a multi-centre study. BMC Cancer, 16(1), 427. https://doi.org/10.1186/s12885-016-2410-2
Roussel, M., Moreau, P., Hebraud, B., Laribi, K., Jaccard, A., Dib, M., Slama, B., Dorvaux, V., Royer, B., Frenzel, L., Zweegman, S., Klein, S. K., Broijl, A., Jie, K.-S., Wang, J., Vanquickelberghe, V., de Boer, C., Kampfenkel, T., Gries, K. S., … Sonneveld, P. (2020). Bortezomib, thalidomide, and dexamethasone with or without daratumumab for transplantation-eligible patients with newly diagnosed multiple myeloma (CASSIOPEIA): health-related quality of life outcomes of a randomised, open-label, phase 3 trial. The Lancet. Haematology, 7(12), e874–e883. https://doi.org/10.1016/S2352-3026(20)30356-2
Schenker, Y., Park, S. Y., Jeong, K., Pruskowski, J., Kavalieratos, D., Resick, J., Abernethy, A., & Kutner, J. S. (2019). Associations Between Polypharmacy, Symptom Burden, and Quality of Life in Patients with Advanced, Life-Limiting Illness. Journal of General Internal Medicine, 34(4), 559–566. https://doi.org/10.1007/s11606-019-04837-7
Selvy, M., Kerckhove, N., Pereira, B., Barreau, F., Nguyen, D., Busserolles, J., Giraudet, F., Cabrespine, A., Chaleteix, C., Soubrier, M., Bay, J. O., Lemal, R., & Balayssac, D. (2021). Prevalence of Chemotherapy-Induced Peripheral Neuropathy in Multiple Myeloma Patients and its Impact on Quality of Life: A Single Center Cross-Sectional Study. Frontiers in Pharmacology, 12(April), 1–12. https://doi.org/10.3389/fphar.2021.637593
Shaheen, N., Alqahtani, M., Alawbthani, N., Thomas, A., & Alaskar, A. (2020). Chemotherapy-induced peripheral neuropathy and its impact on health-related quality of life among multiple myeloma patients: A single-center experience. Indian Journal of Palliative Care, 26(4), 506–511. https://doi.org/10.4103/IJPC.IJPC_233_19
Simão, D. A. da S., Teixeira, A. L., Souza, R. S., & Lima, E. D. R. de P. (2014). Evaluation of the Semmes–Weinstein filaments and a questionnaire to assess chemotherapy-induced peripheral neuropathy. Supportive Care in Cancer, 22(10), 2767–2773. https://doi.org/10.1007/s00520-014-2275-3
Stewart, A. K., Dimopoulos, M. A., Masszi, T., Špička, I., Oriol, A., Hájek, R., Rosiñol, L., Siegel, D. S., Niesvizky, R., Jakubowiak, A. J., San-Miguel, J. F., Ludwig, H., Buchanan, J., Cocks, K., Yang, X., Xing, B., Zojwalla, N., Tonda, M., Moreau, P., & Palumbo, A. (2016). Health-Related Quality-of-Life Results From the Open-Label, Randomized, Phase III ASPIRE Trial Evaluating Carfilzomib, Lenalidomide, and Dexamethasone Versus Lenalidomide and Dexamethasone in Patients With Relapsed Multiple Myeloma. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 34(32), 3921–3930. https://doi.org/10.1200/JCO.2016.66.9648
Stewart, A. K., Rajkumar, S. V., Dimopoulos, M. A., Masszi, T., Špička, I., Oriol, A., Hájek, R., Rosiñol, L., Siegel, D. S., Mihaylov, G. G., Goranova-Marinova, V., Rajnics, P., Suvorov, A., Niesvizky, R., Jakubowiak, A. J., San-Miguel, J. F., Ludwig, H., Wang, M., Maisnar, V., Palumbo, A. (2015). Carfilzomib, Lenalidomide, and Dexamethasone for Relapsed Multiple Myeloma. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1411321
Sully, K., Trigg, A., Bonner, N., Yucel, E., Koehler, A. M., Panjabi, S., Cocks, K., Trennery, C., & Shah, N. (2019). Estimation of minimally important differences and responder definitions for EORTC QLQ ‐ MY20 scores in multiple myeloma patients. August, 500–509. https://doi.org/10.1111/ejh.13316
Tegegn, H. G., Erku, D. A., Sebsibe, G., Gizaw, B., Seifu, D., Tigabe, M., Belachew, S. A., & Ayele, A. A. (2019). Medication-related quality of life among Ethiopian elderly patients with polypharmacy: A cross-sectional study in an Ethiopia university hospital. PloS One, 14(3), e0214191–e0214191. https://doi.org/10.1371/journal.pone.0214191
van der Poel, M. W. M., Oerlemans, S., Schouten, H. C., & van de Poll-Franse, L. V. (2015). Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry. Annals of Hematology, 94(4), 651–661. https://doi.org/10.1007/s00277-014-2264-0
Warsame, R., & D’Souza, A. (2019). Patient Reported Outcomes Have Arrived: A Practical Overview for Clinicians in Using Patient Reported Outcomes in Oncology. Mayo Clinic Proceedings, 94(11), 2291–2301. https://doi.org/10.1016/j.mayocp.2019.04.005
Zanwar, S., Abeykoon, J. P., & Kapoor, P. (2019). Challenges and Strategies in the Management of Multiple Myeloma in the Elderly Population. Current Hematologic Malignancy Reports, 14(2), 70–82. https://doi.org/10.1007/s11899-019-00500-4
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Paula Lana de Miranda Drummond; Roberta Márcia Marques dos Santos; Adriano Max Moreira Reis; Jéssica Soares Malta; Lívia Pena Silveira; Iwyson Henrique Fernandes da Costa; Bárbara Soares Diniz Marques; Roberta Oliveira de Paula e Silva; Evandro Maranhão Fagundes; Enrico Antônio Colosimo; Cristiane Aparecida Menezes de Pádua
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
