Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.
Health Qual Life Outcomes. 2021 Nov 4;19(1):251. doi: 10.1186/s12955-021-01887-6.
Patients with hematological cancer who experience relapse or progressive disease often face yet another line of treatment and continued mortality risk that could increase their physical and emotional trauma and worsen their health-related quality of life. Healthcare professionals who use patient-reported outcomes to identify who will have specific sensitivities in particular health-related quality of life domains may be able to individualize and target treatment and supportive care, both features of precision medicine. Here, in a cohort of patients with relapsed or progressive hematological cancer, we sought to identify health-related quality of life domains in which they experienced deterioration after relapse treatment and to investigate health-related quality of life patterns.
Patients were recruited in connection with a precision medicine study at the Department of Hematology, Aalborg University Hospital. They completed the European Organization for Research and Treatment of Cancer questionnaire and the Hospital Anxiety and Depression Scale at baseline and at 3, 6, 9, and 12 months after the relapse diagnosis or progressive cancer. Modes of completion were electronically or on paper. Clinically relevant changes from baseline to 12 months were interpreted according to Cocks' guidelines. We quantified the number of patients with moderate or severe symptoms and functional problems and the number who experienced improvements or deterioration from baseline to 12 months.
A total of 104 patients were included, of whom 90 (87%) completed baseline questionnaires and 50 (56%) completed the 12-month assessments. The three symptoms that patients most often reported as deteriorating were fatigue (18%), insomnia (18%), and diarrhea (18%). The three functions that patients most often reported as deteriorating were role (16%) and emotional (16%) and cognitive (16%) functioning.
In this study, patient-reported outcome data were useful for identifying negatively affected health-related quality of life domains in patients with relapsed or progressive hematological cancer. We identified patients experiencing deterioration in health-related quality of life during treatment and characterized a potential role for patient-reported outcomes in precision medicine to target treatment and supportive care in this patient group.
患有血液系统恶性肿瘤的患者在经历复发或疾病进展后，通常需要接受新的一线治疗，并且仍面临死亡风险，这可能会给他们带来身体和心理创伤，进一步降低其健康相关生活质量。使用患者报告结局来识别特定健康相关生活质量领域中具有特定敏感性的医疗保健专业人员，可能能够对治疗和支持性护理进行个体化和靶向治疗，这些都是精准医学的特征。在此，我们在复发或进展性血液系统恶性肿瘤患者队列中，旨在确定患者在复发治疗后经历健康相关生活质量恶化的领域，并调查健康相关生活质量模式。
患者是在奥尔堡大学医院血液科的一项精准医学研究中招募的。他们在复发诊断或进展性癌症后，分别在基线时以及 3、6、9 和 12 个月时，完成欧洲癌症研究与治疗组织问卷和医院焦虑和抑郁量表。完成方式可以是电子方式或纸质方式。根据科克斯指南，将基线至 12 个月的临床相关变化进行解释。我们量化了出现中度或重度症状和功能问题的患者数量，以及从基线到 12 个月出现改善或恶化的患者数量。
共纳入 104 例患者，其中 90 例（87%）完成了基线问卷，50 例（56%）完成了 12 个月的评估。患者报告恶化最多的三种症状是疲劳（18%）、失眠（18%）和腹泻（18%）。患者报告恶化最多的三种功能是角色（16%）、情感（16%）和认知（16%）功能。
在这项研究中，患者报告结局数据可用于识别复发或进展性血液系统恶性肿瘤患者中受影响的健康相关生活质量领域。我们发现患者在治疗过程中健康相关生活质量下降，并确定患者报告结局在精准医学中的潜在作用，以针对该患者群体的治疗和支持性护理进行靶向治疗。
