Abstract
Purpose
Cross-sectional observational studies indicate that patients with multiple myeloma (MM) experience negative physical and psychological symptoms and low health-related quality of life (HRQOL). The study aim was to determine symptom prevalence, symptom trajectories, HRQOL, and symptoms associated with HRQOL in patients with MM.
Methods
This multicenter longitudinal cohort study was conducted in four hospitals in Japan. Patients with newly diagnosed MM were asked to report their symptom intensity and HRQOL using validated questionnaires at three points: at diagnosis (T1), 1 month (T2), and 12 months after diagnosis (T3). Symptoms associated with HRQOL were explored using a mixed-effect model.
Results
A total of 106 patients completed the assessment at T1. The most frequently reported symptoms were pain and disturbed sleep at T1; pain and dry mouth at T2; and fatigue, numbness or tingling, and pain at T3. Three symptom trajectory patterns were identified: a peak at T1 and reduction over time (pain, disturbed sleep, distress, lack of appetite, sadness, depression), a peak at T2 (fatigue, drowsiness, dry mouth, nausea, vomiting), and a V-shaped pattern (shortness of breath, numbness or tingling, difficulty remembering). Pain, depression, and gastrointestinal symptoms were significantly associated with HRQOL.
Conclusion
The finding that more than 30% of MM patients experienced pain and various symptoms indicates that patients had substantial palliative care needs within a year after starting initial chemotherapy. Different symptom trajectories were identified. Pain, depression, and gastrointestinal symptoms should be the main targets of palliative care interventions to improve HRQOL in this population.
Health-related quality of life results from the IFM 2009 trial: treatment with lenalidomide, bortezomib, and dexamethasone in transplant-eligible patients with newly diagnosed multiple myeloma
