Division of Hematology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Oncologist. 2022 Aug 5;27(8):694-702. doi: 10.1093/oncolo/oyac079.
The plasma cell disorders (PCDs), multiple myeloma (MM), and light-chain amyloidosis (AL) are disproportionately diseases of older adults, whose care may be complicated by frailty associated with advancing age. We sought to evaluate the prevalence of functional deficits and symptoms in a cohort of persons with PCDs and associations of demographic, disease-related, functional, and psychosocial measures with quality of life (QoL).
Adults with PCDs were recruited into an observational registry in 2018-2020. Patients completed a functional assessment and European Organization for Research and Treatment of Cancer QoL questionnaire (QLQ-C30). Associations of covariates of interest with QoL were evaluated via univariate linear regression.
Among 121 adults, the mean age was 68.6. Diagnoses were 74% MM, 14% AL, 7% both MM and AL, and 5% other PCDs. The median time from diagnosis was 34.9 months. Median lines of therapy were 2, with 11% having received ≥4th-line therapy.Patients with functional deficits had lower mean QoL scores: dependence in IADLs (66.3 vs. 79.9, P = .001) and recent falls (56.7 vs. 76.8, P = .001). Patients ≤6 months from diagnosis had lower QoL (66.7) than those ≥2 years from diagnosis (77.3, P = .03). However, patients on later lines of therapy (≥4th-line) had lower QoL (62.2) than those on 1st-line treatment (76.0, P = .04).
Patients with physical impairments and more advanced PCDs had lower QoL than those without deficits or earlier in their disease course. Early identification of physical impairments may facilitate interventions that mitigate these deficits and thereby improve QoL for patients with PCDs.
浆细胞疾病（PCD）、多发性骨髓瘤（MM）和轻链淀粉样变性（AL）在老年人中发病率较高，这些患者的护理可能因与年龄相关的虚弱而变得复杂。我们旨在评估一组 PCD 患者的功能缺陷和症状的患病率，并评估人口统计学、疾病相关、功能和社会心理因素与生活质量（QoL）的关系。
2018-2020 年期间，我们招募了 PCD 患者进入观察性登记处。患者完成了功能评估和欧洲癌症研究与治疗组织 QoL 问卷（QLQ-C30）。通过单变量线性回归评估了感兴趣的协变量与 QoL 的相关性。
在 121 名成年人中，平均年龄为 68.6 岁。诊断为 74%的 MM、14%的 AL、7%的 MM 和 AL 并存、5%的其他 PCD。从诊断到中位时间为 34.9 个月。中位治疗线数为 2 条，有 11%的患者接受了≥4 线治疗。有功能缺陷的患者的 QoL 评分较低：IADL 依赖（66.3 对 79.9，P =.001）和最近跌倒（56.7 对 76.8，P =.001）。距诊断<6 个月的患者 QoL 较低（66.7），而距诊断≥2 年的患者 QoL 较高（77.3，P =.03）。然而，接受较后线治疗（≥4 线）的患者 QoL 较低（62.2），而接受一线治疗的患者 QoL 较高（76.0，P =.04）。
有身体损伤和更晚期 PCD 的患者比无缺陷或疾病早期患者的 QoL 较低。早期识别身体损伤可能有助于实施干预措施，减轻这些缺陷，从而提高 PCD 患者的 QoL。
