Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Division of Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan.
Jpn J Clin Oncol. 2022 Feb 5;52(2):163-169. doi: 10.1093/jjco/hyab178.
Existing cross-sectional observational studies indicate that patients with multiple myeloma experience negative physical and psychological symptoms and low health-related quality of life. The study aim was to determine symptom prevalence, health-related quality of life and symptoms associated with health-related quality of life in patients with newly diagnosed multiple myeloma.
This multicenter longitudinal cohort study was conducted in four hospitals in Japan. Patients with newly diagnosed multiple myeloma were asked to report their symptom intensity and health-related quality of life using validated questionnaires at three points: at diagnosis (T1), 1 month (T2) and 12 months after diagnosis (T3). Symptoms associated with health-related quality of life were explored using a mixed-effects model.
A total of 106 patients completed the assessment at T1. The symptoms more than 30% of patients reported were pain, disturbed sleep and distress at T1, pain, dry mouth, disturbed sleep and fatigue at T2, fatigue, numbness of tingling and pain and numbness or tingling at T3. Pain and depression were significantly associated with health-related quality of life negatively.
The finding suggests that more than 30% of multiple myeloma patients suffered from pain and various symptoms and they received suboptimal palliative care within a year after starting initial chemotherapy. Pain and depression should be the main targets of interventions to improve health-related quality of life in this population.
现有的横断面观察性研究表明，多发性骨髓瘤患者经历负面的生理和心理症状以及较低的健康相关生活质量。本研究旨在确定新诊断多发性骨髓瘤患者的症状发生率、健康相关生活质量以及与健康相关生活质量相关的症状。
本多中心纵向队列研究在日本的四家医院进行。新诊断为多发性骨髓瘤的患者在三个时间点（T1、T2 和 T3）使用经过验证的问卷报告其症状强度和健康相关生活质量：诊断时（T1）、1 个月（T2）和诊断后 12 个月（T3）。使用混合效应模型探索与健康相关生活质量相关的症状。
共有 106 名患者完成了 T1 时的评估。30%以上的患者报告的症状是 T1 时的疼痛、睡眠障碍和痛苦、T2 时的疼痛、口干、睡眠障碍和疲劳、T3 时的疲劳、麻木刺痛和疼痛以及麻木或刺痛。疼痛和抑郁与健康相关生活质量呈显著负相关。
这一发现表明，30%以上的多发性骨髓瘤患者患有疼痛和各种症状，并且在开始初始化疗后的一年内接受了不充分的姑息治疗。疼痛和抑郁应该是改善该人群健康相关生活质量干预的主要目标。
