Massachusetts General Hospital Cancer Center, Boston, MA.
Harvard Medical School, Boston, MA.
Blood Adv. 2022 Sep 13;6(17):4967-4974. doi: 10.1182/bloodadvances.2022007127.
Although caregivers of patients with multiple myeloma (MM) play a critical role in supporting their loved ones throughout the illness course, studies examining caregiver quality of life (QOL), psychological distress, and prognostic awareness are lacking. We conducted a cross-sectional, multisite study of patients undergoing treatment with MM and their caregivers. Eligible caregivers were enrolled to 1 of 3 cohorts based on lines of therapy. Caregivers completed validated questionnaires to assess their QOL, psychological distress, and perceptions of prognosis. We enrolled 127 caregivers of patients with MM (newly diagnosed [n = 43], 2-3 lines of therapy [n = 40], and ≥4 lines of therapy [n = 44]). Caregiver QOL and psychological distress did not differ by line of therapy. The rate of clinically significant anxiety, depression, and posttraumatic stress disorder symptoms were 44.1% (56/127), 15.8% (20/127), and 24.4% (31/127), respectively. When examined in dyads, caregivers reported higher rates of clinically significant anxiety (44.4% [55/124] vs 22.5% [28/124]) compared with patients with MM. Most caregivers (84.2%, 101/120) reported that the oncologist had informed them that the patient's cancer was incurable; however, only 50.9% (58/114) and 53.6% (59/110) of caregivers acknowledged the patient's cancer was terminal and incurable, respectively. Caregivers of patients undergoing treatment for MM experience substantial psychological distress across the disease continuum, particularly anxiety. The majority of caregivers of patients with MM report that knowing the patient's prognosis is extremely important and report that the oncologist told them that the patient was incurable. Nevertheless, a significant portion of caregivers believe that the patient's MM is curable.
尽管多发性骨髓瘤(MM)患者的照顾者在整个疾病过程中为支持亲人发挥着关键作用,但缺乏研究来检查照顾者的生活质量(QOL)、心理困扰和预后意识。我们对接受 MM 治疗的患者及其照顾者进行了一项横断面、多中心研究。根据治疗线数,将符合条件的照顾者纳入 3 个队列之一。照顾者完成了经过验证的问卷,以评估他们的 QOL、心理困扰和对预后的看法。我们招募了 127 名 MM 患者的照顾者(新诊断[43 名]、2-3 线治疗[40 名]和≥4 线治疗[44 名])。照顾者的 QOL 和心理困扰与治疗线数无关。临床显著焦虑、抑郁和创伤后应激障碍症状的发生率分别为 44.1%(56/127)、15.8%(20/127)和 24.4%(31/127)。在双体中检查时,照顾者报告的临床显著焦虑发生率高于 MM 患者(44.4%[55/124]比 22.5%[28/124])。大多数照顾者(84.2%,101/120)报告说肿瘤医生已经告诉他们患者的癌症是无法治愈的;然而,只有 50.9%(58/114)和 53.6%(59/110)的照顾者承认患者的癌症是终末期和无法治愈的。接受 MM 治疗的患者的照顾者在整个疾病过程中经历了相当大的心理困扰,特别是焦虑。大多数 MM 患者的照顾者报告说,了解患者的预后极其重要,并报告说肿瘤医生告诉他们患者的癌症是无法治愈的。然而,仍有相当一部分照顾者认为患者的 MM 是可治愈的。