Strasser-Weippl Kathrin, Ludwig Heinz
1st Medical Department, Center for Haematology and Medical Oncology, Wilhelminenspital, Vienna, Austria.
Eur J Haematol. 2008 Nov;81(5):374-9. doi: 10.1111/j.1600-0609.2008.01126.x. Epub 2008 Jul 11.
Only few studies have analyzed quality of life (QOL) and its association with prognosis in patients with multiple myeloma. We studied QOL at start of conventional treatment to evaluate the impact of symptomatic myeloma on QOL and to determine the prognostic significance of various dimensions of QOL. Our study provided further evidence of the significant impairment of QOL in patients with multiple myeloma at onset of therapy. Furthermore, our data showed a closer correlation between the more physical QOL scales such as pain, fatigue, physical functioning and global QOL with the activity of the disease than between psychosocial dimensions such as role, emotional, social, and cognitive functioning and the status of the disease. Multivariate analyses including each a QOL scale and known prognostic parameters (response to therapy, creatinine level, calcium, LDH, Hb, beta2-microglobulin, and albumin) revealed a marked difference in the prognostic significance between psychosocial and other QOL scales. All psychosocial dimensions of QOL were found to be independent prognostic factors, while physical QOL and global QOL were eliminated by disease-associated prognosticators. Taken together, QOL was found to be significantly impaired in myeloma patients at start of therapy. Psychosocial, but not physical dimensions of QOL were found to be independent prognostic factors.
仅有少数研究分析了多发性骨髓瘤患者的生活质量（QOL）及其与预后的关联。我们在传统治疗开始时研究了生活质量，以评估有症状的骨髓瘤对生活质量的影响，并确定生活质量各维度的预后意义。我们的研究进一步证明了多发性骨髓瘤患者在治疗开始时生活质量受到显著损害。此外，我们的数据显示，与角色、情感、社会和认知功能等心理社会维度相比，疼痛、疲劳、身体功能和总体生活质量等更多身体方面的生活质量量表与疾病活动之间的相关性更强。包括各生活质量量表和已知预后参数（对治疗的反应、肌酐水平、钙、乳酸脱氢酶、血红蛋白、β2-微球蛋白和白蛋白）的多变量分析显示，心理社会生活质量量表与其他生活质量量表在预后意义上存在显著差异。发现生活质量的所有心理社会维度都是独立的预后因素，而身体生活质量和总体生活质量则被疾病相关的预后因素所排除。综上所述，骨髓瘤患者在治疗开始时生活质量明显受损。发现生活质量的心理社会维度而非身体维度是独立的预后因素。
