Quality of Life Research Center, Department of Haematology, Odense University Hospital, Kløvervænget 10, 12. floor, 5000, Odense C, Denmark.
Department of Internal Medicine and Cardiology, Regional Hospital Viborg, Viborg, Denmark.
Ann Hematol. 2021 Sep;100(9):2311-2323. doi: 10.1007/s00277-020-04356-0. Epub 2021 Jan 6.
Patients with multiple myeloma (MM) report high symptom burden and functional disabilities resulting in impaired health-related quality of life (HRQoL). Effective evidence-based rehabilitation guidelines are needed for patients with MM to improve HRQoL. The primary aim of this study was to investigate HRQoL in patients with rehabilitation needs living their everyday life. Patients with MM in remission attended a 12-week multidisciplinary rehabilitation program including a 5-day residential course, home-based exercise and a 2-day follow-up course. The patients were referred by the treating haematologist and completed a booklet of validated HRQoL questionnaires at baseline and before arriving for the 2-day follow-up course. The proportion of participants with moderate to severe symptoms and functional problems were assessed at the two time points and multivariate logistic regression was used to investigate explaining factors of impaired HRQoL at baseline. Ninety-two patients participated with a follow-up compliance rate of 90%. Median age was 67 years and median time since diagnosis was 26 months (ranged 5 months to 15.6 years). The most frequently reported symptoms were global quality of life, role functioning, fatigue, pain, peripheral neuropathy and physical functioning. Pain and fatigue were both highly coherent with impairment in physical functioning and those two symptoms explained most HRQoL impairments. Overall, the participants reported no change in HRQoL after the 12-week rehabilitation program. The study supports the need for an evidence-based guideline for rehabilitation and palliative care to patients with MM in remission living their everyday life.
多发性骨髓瘤（MM）患者报告有较高的症状负担和功能障碍，导致健康相关生活质量（HRQoL）受损。需要为 MM 患者制定有效的循证康复指南，以提高 HRQoL。本研究的主要目的是调查日常生活中具有康复需求的 MM 患者的 HRQoL。缓解期的 MM 患者参加了为期 12 周的多学科康复计划，包括为期 5 天的住院课程、家庭运动和为期 2 天的随访课程。这些患者是由主治血液学家推荐的，并在基线和参加 2 天随访课程之前完成了一本经验证的 HRQoL 问卷手册。在这两个时间点评估了有中度至重度症状和功能问题的参与者的比例，并使用多变量逻辑回归来调查基线时 HRQoL 受损的解释因素。92 名患者参与了该研究，随访依从率为 90%。中位年龄为 67 岁，中位诊断后时间为 26 个月（范围为 5 个月至 15.6 年）。报告最频繁的症状是总体生活质量、角色功能、疲劳、疼痛、周围神经病变和身体功能。疼痛和疲劳均与身体功能障碍高度相关，这两个症状解释了大多数 HRQoL 受损的原因。总体而言，患者在 12 周康复计划后报告 HRQoL 没有变化。该研究支持为缓解期日常生活中的 MM 患者制定基于证据的康复和姑息治疗指南的必要性。
