TY - JOUR
T1 - Trajectories of quality of life recovery and symptom burden after autologous hematopoietic cell transplantation in multiple myeloma
AU - D'Souza, Anita
AU - Brazauskas, Ruta
AU - Stadtmauer, Edward A.
AU - Pasquini, Marcelo C.
AU - Hari, Parameswaran
AU - Bashey, Asad
AU - Callander, Natalie
AU - Devine, Steven
AU - Efebera, Yvonne
AU - Ganguly, Siddhartha
AU - Gasparetto, Cristina
AU - Geller, Nancy
AU - Horowitz, Mary M.
AU - Koreth, John
AU - Landau, Heather
AU - Brunstein, Claudio
AU - McCarthy, Philip
AU - Qazilbash, Muzaffar H.
AU - Giralt, Sergio
AU - Krishnan, Amrita
AU - Flynn, Kathryn E.
N1 - Funding Information:
This ancillary study was funded by a Froedtert & MCW Cancer Center grant (project 3379013). Dr. D'Souza is supported by K23 HL141445. The BMT CTN 0702 was supported by Grant No. U10HL069294 to the Blood and Marrow Transplant Clinical Trials Network from the National Heart, Lung, and Blood Institute and the National Cancer Institute; by Celgene Corporation and Millennium (Takeda) Pharmaceuticals; and by The Alliance for Clinical Trials in Oncology, the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network Cancer Research Group, and SWOG.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2023/1
Y1 - 2023/1
N2 - Early autologous hematopoietic cell transplantation (AHCT) with post-transplant maintenance therapy is standard of care in multiple myeloma (MM). While short-term quality of life (QOL) deterioration after AHCT is known, the long-term trajectories and symptom burden after transplantation are largely unknown. Toward this goal, a secondary analysis of QOL data of the BMT CTN 0702, a randomized controlled trial comparing outcomes of three treatment interventions after a single AHCT (N = 758), was conducted. FACT-BMT scores up to 4 years post-AHCT were analyzed. Symptom burden was studied using responses to 17 individual symptoms dichotomized as ‘none/mild’ for scores 0–2 and ‘moderate/severe’ for scores of 3 or 4. Patients with no moderate/severe symptom ratings were considered to have low symptom burden at 1-year. Mean age at enrollment was 55.5 years with 17% African Americans. Median follow-up was 6 years (range, 0.4–8.5 years). FACT-BMT scores improved between enrollment and 1-year and remained stable thereafter. Low symptom burden was reported by 27% of patients at baseline, 38% at 1-year, and 32% at 4 years post-AHCT. Predictors of low symptom burden at 1-year included low symptom burden at baseline: OR 2.7 (1.8–4.1), p < 0.0001; older age: OR 2.1 (1.3–3.2), p = 0.0007; and was related to being employed: OR 2.1 (1.4–3.2), p = 0.0004). We conclude that MM survivors who achieve disease control after AHCT have excellent recovery of FACT-BMT and subscale scores to population norms by 1-year post-transplant, though many patients continue to report moderate to severe severity in some symptoms at 1-year and beyond.
AB - Early autologous hematopoietic cell transplantation (AHCT) with post-transplant maintenance therapy is standard of care in multiple myeloma (MM). While short-term quality of life (QOL) deterioration after AHCT is known, the long-term trajectories and symptom burden after transplantation are largely unknown. Toward this goal, a secondary analysis of QOL data of the BMT CTN 0702, a randomized controlled trial comparing outcomes of three treatment interventions after a single AHCT (N = 758), was conducted. FACT-BMT scores up to 4 years post-AHCT were analyzed. Symptom burden was studied using responses to 17 individual symptoms dichotomized as ‘none/mild’ for scores 0–2 and ‘moderate/severe’ for scores of 3 or 4. Patients with no moderate/severe symptom ratings were considered to have low symptom burden at 1-year. Mean age at enrollment was 55.5 years with 17% African Americans. Median follow-up was 6 years (range, 0.4–8.5 years). FACT-BMT scores improved between enrollment and 1-year and remained stable thereafter. Low symptom burden was reported by 27% of patients at baseline, 38% at 1-year, and 32% at 4 years post-AHCT. Predictors of low symptom burden at 1-year included low symptom burden at baseline: OR 2.7 (1.8–4.1), p < 0.0001; older age: OR 2.1 (1.3–3.2), p = 0.0007; and was related to being employed: OR 2.1 (1.4–3.2), p = 0.0004). We conclude that MM survivors who achieve disease control after AHCT have excellent recovery of FACT-BMT and subscale scores to population norms by 1-year post-transplant, though many patients continue to report moderate to severe severity in some symptoms at 1-year and beyond.
KW - Humans
KW - Middle Aged
KW - Multiple Myeloma/therapy
KW - Quality of Life
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Transplantation, Autologous
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U2 - 10.1002/ajh.26596
DO - 10.1002/ajh.26596
M3 - Article
C2 - 35567778
AN - SCOPUS:85130262056
SN - 0361-8609
VL - 98
SP - 140
EP - 147
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 1
ER -