Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: results of a European, multicenter cohort study

Abstract

Purpose: Novel multiple myeloma (MM) therapies have increased patient longevity but are often associated with notable symptom burden. This study quantified the effect of general symptom level, specific symptoms, and treatment-related adverse events (AEs) on MM patients' health-related quality of life (HRQoL).

Methods: The European Organization for Research and Treatment of Cancer (EORTC) generic cancer questionnaire (Quality of Life Questionnaire Core 30) and MM-specific questionnaire (QLQ-MY20) were used in this study to assess patients' HRQoL. Data were collected on sociodemographics, disease and treatment history, and the presence/severity of MM-related symptoms or treatment-related AEs from patients with MM in UK and German centers. Multiple regression analyses were conducted.

Results: Of 154 patients (63 % male; mean age, 66.4 years; mean time since diagnosis, 3.7 years; 52 % currently on treatment; and 43 % with ≥ 1 prior MM therapy), 25, 32, 31, and 11 % were severely symptomatic, moderately symptomatic, mildly symptomatic, and asymptomatic, respectively. Fatigue (59 %), bone pain (51 %), sleepiness (36 %), hypoesthesia or paresthesia (33 %), and muscle cramps (31 %) were most commonly reported. Moderate and severe general symptom levels, bone symptoms, depression, and mental status changes were identified as strong determinants of HRQoL.

Conclusions: Severity, type of disease symptoms, and treatment related AEs are important HRQoL determinants in patients with MM, allowing for targeted treatment.

Fig. 1

Frequently reported multiple myeloma symptoms and adverse events. Collapse of vertebral body, bone fracture, abdominal pain, petechiae/purpura, gastrointestinal bleeding, upper respiratory tract infection, pneumonia, fever, febrile neutropenia, diarrhea, asthenia or tiredness, anorexia, dyspepsia, motor neuropathy, carpal tunnel syndrome, syncope, states of confusion, mental status changes, cerebrovascular accident, rash, deep-vein thrombosis, hypotension, and renal failure were reported by <10 % of patients

Fig. 2

Distribution of health-related quality of life by symptom level: Global Health Status/Quality of Life (QoL), Physical Functioning, Social Functioning, and Future Perspective. Higher scores are “better”; error bars represent standard deviation

Fig. 3

Distribution of health-related quality of life by symptom level: Fatigue and Disease Symptoms. Lower scores are “better”; error bars represent standard deviation