Patient-Reported Outcomes in Long-Term Survivors of Autologous Hematopoietic Cell Transplantation in Multiple Myeloma
Chakraborty, Rajshekhar ; Yi, Jean ; Rybicki, Lisa ; Preussler, Jaime ; Deol, Abhinav ; Loren, Alison ; Savani, Bipin ; Jim, Heather S L ; Cerny, Jan ; Reynolds, Jana ... show 10 more
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Authors
Yi, Jean
Rybicki, Lisa
Preussler, Jaime
Deol, Abhinav
Loren, Alison
Savani, Bipin
Jim, Heather S L
Cerny, Jan
Reynolds, Jana
Whitten, Jennifer
Wingard, John R
McGuirk, Joseph P
Uberti, Joseph
Khera, Nandita
Stiff, Patrick
Jaglowski, Samantha M
Hashmi, Shahrukh
Holtan, Shernan G
Devine, Steven
Hahn, Theresa
Whalen, Victoria L
Saber, Wael
Wood, William
Baker, K Scott
Syrjala, Karen
Majhail, Navneet S
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UMass Chan Affiliations
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Abstract
The overall survival in patients with transplantation-eligible multiple myeloma has tripled over the past 2 decades, leading to a growing population of myeloma survivors. However, there is a paucity of data on health-related quality of life (HRQoL), distress, and health behaviors in long-term myeloma survivors who are in stable remission after autologous hematopoietic cell transplantation (AHCT). In this cross-sectional study using data from 2 randomized controlled trials of survivorship care plans and internet-based self-management intervention in transplantation survivors, the primary objective was to measure HRQoL (using the Short Form-12, version 2.0 [SF-12 v2]), distress (using the Cancer- and Treatment-Related Distress [CTXD] instrument), and health behaviors of myeloma survivors in stable remission after AHCT. A total of 345 patients at a median of 4 years (range, 1.4 to 11 years) post-AHCT were included. The mean SF-12 v2 Physical Component Summary (PCS) score was 45.5 ± 10.5, and the mean Mental Component Summary (MCS) score was 51.3 ± 10.1, compared with US population norms of 50 ± 10 for both (P < .001 and P = .021 for PCS and MCS comparisons, respectively). Notably, neither reached the threshold for a minimal clinically important difference. Approximately one-third of the patients had clinically significant distress based on the CTXD total score, with distress reported by 53% of the patients in the Health Burden domain, by 46% in the Uncertainty domain, by 33% in the Finances domain, by 31% in the Family Strain domain, by 21% in the Identity domain, and by 15% in the Medical Demands domain. Preventive care guidelines were adhered to by 81% of the myeloma survivors; however, adherence to exercise and diet guidelines were relatively low, at 33% and 13%, respectively. Myeloma AHCT survivors in stable remission have no clinically meaningful worsening in physical functioning compared with the general population. Survivorship programs should address ongoing distress due to health burden, uncertainty, and finances in myeloma survivors, along with evidence-based targeted interventions for modifiable health behaviors, such as nutrition and exercise.
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Chakraborty R, Yi J, Rybicki L, Preussler J, Deol A, Loren A, Savani B, Jim HSL, Cerny J, Reynolds J, Whitten J, Wingard JR, McGuirk JP, Uberti J, Khera N, Stiff P, Jaglowski SM, Hashmi S, Holtan SG, Devine S, Hahn T, Whalen VL, Saber W, Wood W, Baker KS, Syrjala K, Majhail NS. Patient-Reported Outcomes in Long-Term Survivors of Autologous Hematopoietic Cell Transplantation in Multiple Myeloma. Transplant Cell Ther. 2023 Jun;29(6):388.e1-388.e6. doi: 10.1016/j.jtct.2023.02.011. Epub 2023 Mar 2. PMID: 36870388; PMCID: PMC10718487.