Indiana University, Indianapolis, IN, USA.
Hematology/Oncology, Indiana Cancer Pavilion, 535 Barnhill Drive, Suite 446, Indianapolis, IN, 46202-5289, USA.
Ann Hematol. 2018 Dec;97(12):2425-2436. doi: 10.1007/s00277-018-3446-y. Epub 2018 Jul 29.
Maintenance therapy after autologous stem cell transplantation (ASCT) is recommended for use in multiple myeloma (MM); however, more data are needed on its impact on health-related quality of life (HRQoL). Presented here is an analysis of HRQoL in a Connect MM registry cohort of patients who received ASCT ± maintenance therapy. The Connect MM Registry is one of the earliest and largest, active, observational, prospective US registry of patients with symptomatic newly diagnosed MM. Patients completed the Functional Assessment of Cancer Therapy-MM (FACT-MM) version 4, EuroQol-5D (EQ-5D) questionnaire, and Brief Pain Inventory (BPI) at study entry and quarterly thereafter until death or study discontinuation. Patients in three groups were analyzed: any maintenance therapy (n = 244), lenalidomide-only maintenance therapy (n = 169), and no maintenance therapy (n = 137); any maintenance and lenalidomide-only maintenance groups were not mutually exclusive. There were no significant differences in change from pre-ASCT baseline between any maintenance (P = 0.60) and lenalidomide-only maintenance (P = 0.72) versus no maintenance for the FACT-MM total score. There were also no significant differences in change from pre-ASCT baseline between any maintenance and lenalidomide-only maintenance versus no maintenance for EQ-5D overall index, BPI, FACT-MM Trial Outcomes Index, and myeloma subscale scores. In all three groups, FACT-MM, EQ-5D Index, and BPI scores improved after ASCT; FACT-MM and BPI scores deteriorated at disease progression. These data suggest that post-ASCT any maintenance or lenalidomide-only maintenance does not negatively impact patients' HRQoL. Additional research is needed to verify these findings.
自体干细胞移植 (ASCT) 后进行维持治疗已被推荐用于多发性骨髓瘤 (MM);然而,还需要更多数据来评估其对健康相关生活质量 (HRQoL) 的影响。本文分析了接受 ASCT ± 维持治疗的 Connect MM 登记研究队列患者的 HRQoL。Connect MM 登记研究是最早和最大的、活跃的、前瞻性的美国症状性初诊 MM 患者观察性登记研究之一。患者在研究入组时和之后每季度完成功能性评估癌症治疗-MM 量表 (FACT-MM) 第 4 版、欧洲五维健康量表 (EQ-5D) 问卷和简明疼痛量表 (BPI)。分析了三组患者:任何维持治疗 (n=244)、来那度胺单药维持治疗 (n=169) 和无维持治疗 (n=137);任何维持治疗和来那度胺单药维持治疗组并非互斥。与无维持治疗相比,任何维持治疗 (P=0.60) 和来那度胺单药维持治疗 (P=0.72) 从 ASCT 前基线的变化在 FACT-MM 总分上无显著差异。与无维持治疗相比,任何维持治疗和来那度胺单药维持治疗在 EQ-5D 总指数、BPI、FACT-MM 试验结局指数和骨髓瘤亚量表评分方面,从 ASCT 前基线的变化也无显著差异。在所有三组中,FACT-MM、EQ-5D 指数和 BPI 评分在 ASCT 后改善;FACT-MM 和 BPI 评分在疾病进展时恶化。这些数据表明,ASCT 后任何维持治疗或来那度胺单药维持治疗不会对患者的 HRQoL 产生负面影响。需要进一步研究来验证这些发现。