Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio; Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Biol Blood Marrow Transplant. 2018 Aug;24(8):1546-1553. doi: 10.1016/j.bbmt.2018.03.027. Epub 2018 Apr 4.
Autologous stem cell transplantation (ASCT) is an integral part of the frontline therapy in eligible multiple myeloma (MM) patients. The impact of ASCT on health-related quality of life (HRQoL) in myeloma has not been well described. We performed a systematic literature search to identify studies evaluating the impact of ASCT on HRQoL. Our search retrieved 12 relevant studies: 10 manuscripts and 2 conference abstracts. There was a widespread heterogeneity across studies in instruments used to measure HRQoL, time points of measurement, and statistical analysis. Only 1 study was a randomized controlled trial with HRQoL as a prespecified secondary endpoint. The common theme that emerged from most studies is that ASCT leads to an immediate deterioration in HRQoL and increase in symptom burden. However, baseline HRQoL and symptom scores are regained as early as 1 to 2 months post-transplantation. Furthermore, an improvement in HRQoL and pain on long-term follow-up was noted in some studies. We describe opportunities for further research in this area, including routine incorporation of HRQoL as an endpoint in transplant-related clinical trials and need for trials investigating interventions that may improve short and long-term HRQoL in myeloma ASCT recipients.
自体干细胞移植(ASCT)是符合条件的多发性骨髓瘤(MM)患者一线治疗的重要组成部分。ASCT 对骨髓瘤患者健康相关生活质量(HRQoL)的影响尚未得到很好的描述。我们进行了系统的文献检索,以确定评估 ASCT 对 HRQoL 影响的研究。我们的检索共检索到 12 项相关研究:10 篇论文和 2 篇会议摘要。在用于测量 HRQoL 的工具、测量时间点和统计分析方面,研究之间存在广泛的异质性。只有 1 项研究是将 HRQoL 作为预设次要终点的随机对照试验。大多数研究的一个共同主题是,ASCT 导致 HRQoL 立即恶化和症状负担增加。然而,在移植后 1 至 2 个月,基线 HRQoL 和症状评分即可恢复。此外,一些研究还注意到长期随访时 HRQoL 和疼痛的改善。我们描述了在这一领域进一步研究的机会,包括将 HRQoL 作为移植相关临床试验的终点常规纳入,以及需要进行试验以调查可能改善骨髓瘤 ASCT 受者短期和长期 HRQoL 的干预措施。