Persistent Challenges with Treating Multiple Myeloma Early

Blood ◽  
2020 ◽  
Author(s):  
Aaron Michael Goodman ◽  
Myung S Kim ◽  
Vinay Prasad

Over the last decade, two strategies have advanced the treatment of patients with multiple myeloma and precursor diseases. First, the definition has changed to include patients without end organ damage, who previously would not be treated. Second, there is widespread enthusiasm to treat high risk smoldering myeloma. In this commentary, we explore the evidence supporting these therapeutic expansions. While treating early adds cost and therapeutic burden, it remains unknown whether survival or health related quality of life is improved from early treatment. Herein, we consider the implications of diagnostic expansion in multiple myeloma.

2020 ◽  
Author(s):  
Svetlana Vladislavovna Doubova ◽  
Eduardo Terreros-Muñoz ◽  
Nancy Delgado-Lòpez ◽  
Efreen Horacio Montaño-Figueroa ◽  
Claudia Infante-Castañeda ◽  
...  

Abstract Introduction: In Mexico patients with hematologic malignancies (HMs) are characterized by high risk, advanced stages at diagnosis and a low cure rate; yet the information on their experiences with healthcare and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with healthcare and HRQL of patients with HMs.Methods: We conducted a cross-sectional survey in two oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥ 18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess experiences with care and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient experiences and the QLQ-C30 summary score.Results: Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk; 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) received clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychological needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clarity of the information, and care that addresses biopsychological needs were associated with higher HRQL.Conclusions: Healthcare providers are encouraged to measure and address the experiences with healthcare of HM patients to improve the quality of patient-centered cancer care and increase the likelihood of better HRQL.


1996 ◽  
Vol 92 (3) ◽  
pp. 604-613 ◽  
Author(s):  
Finn Wisløff ◽  
Sverre Eika ◽  
Erik Hippe ◽  
Martin Hjorth ◽  
Erik Holmberg ◽  
...  

2021 ◽  
Author(s):  
Ning Cao ◽  
Yunfeng Xi ◽  
Yumin Gao ◽  
Hailing Li ◽  
Yanchao Liu ◽  
...  

Abstract Background The high risk of cardiovascular disease (CVD) being associated with impaired Health-related quality of life (HRQoL). However, few studies have assessed the HRQoL of individuals with a high risk of CVD in Inner Mongolia, or even in China. We aimed to assess health-related quality of life (HRQoL) among individuals in Inner Mongolia with a high risk of CVD and its risk factors, to provide a reference to improve HRQoL in individuals with high CVD risk. Methods From 2015 to 2017, residents of six villages or communities in Inner Mongolia, selected using a multi-stage stratified cluster random sampling method, were invited to complete a questionnaire and undergo physical examination and laboratory testing. We selected participants whose predicted 10-year risk for CVD exceeded 10% as those with high CVD risk. HRQoL in individuals with high CVD risk was investigated based on the EuroQol-5 Dimension (EQ-5D) scale. The Chinese utility value integral system was used to calculate EQ-5D utility scores, and the Tobit regression model were used to analyze the influencing factors of HRQoL among individuals with high CVD risk. Results Of 13,359 participants with high CVD risk, 65.63% reported no problems in any of the five dimensions; the most frequently reported difficulty was pain/discomfort. The mean utility score was 1.000 (0.869, 1.000). Tobit regression analysis showed that sex, age, education level, residence area, household income, physical activity, hypertension, and dyslipidemia were influencing factors of HRQoL. Conclusion We found that female sex, older age, living in an urban area, lower education level, lower household income, and lower physical activity levels were associated with reduced HRQoL. People with a high risk of CVD should maintain their blood glucose and lipid levels within the normal range.


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