(44) Health-Related Quality of Life of Multiple Myeloma Patients from a Brazilian Metropolis Improves After First Line of Treatment

Publication Number: 1089

Background: Multiple myeloma (MM) is a malignant neoplasm whose survival has improved significantly in the past years, with the introduction of thalidomide and bortezomib. However, MM still has no cure and patients will eventually relapse needing subsequent lines of chemotherapy treatment. For this reason, health-related quality of life (HRQoL) is an important patient-report outcome, as well as the factors that can influence on it.

Objectives: The aim of the study was to evaluate whether there was a difference between HRQoL at baseline and after the first line of treatment of MM patients and to assess the associated factors to HRQoL after treatment.

Methods: In this is cohort study, newly diagnosed MM (NDMM) patients attending a public hospital and a private onco-hematology clinic in Belo Horizonte, Brazil, were recruited between April/2019 and March/2020. Socio-demographic and clinical data were obtained from interviews at the beginning of chemotherapy and after autologous stem cell transplantation (ASCT), or after about 12 months from baseline. Medical charts were revised. Validated tools were used to assess HRQoL (EORTC QLQ-C30, QLQ-MY20) and peripheral neuropathy (Chemotherapy-Induced Neurotoxicity Questionnaire). Descriptive analyzes were performed to characterize the population. Wilcoxon test was used to compare the medians of HRQoL scores at baseline and after treatment. Mann-Whitney U and Kruskal-Wallis tests were used to compare the median scores of each HRQoL scale by group of variables.

Results: Thirty-three patients completed the study follow-up. Patients median age was of 66.5 years, 52.8% were females, 41.7% declared white skin, 61.1% had low family income, 41.7% had low education, and 41.7% attended public health service. Most patients had ISS II (41.7%), 77.8% had comorbidities, and 72.7% were in polypharmacy; 42.4% had been submitted to ASCT; 39.4% used thalidomide-based and 18.2% VTd (thalidomide+bortezomib) regimen. The difference in the medians of the HRQoL scores was statistically significant (p < 0.05) at the comparison between baseline and after 1st line chemotherapy for seven HRQoL scales. Lower family income and peripheral neuropathy reflected on worse HRQoL scores; receiving ASCT suggested better scores. Patients using VTd regimen achieved better scores compared to thalidomide-based regimens.

Conclusion: HRQoL of NDMM patients can be improved after 1st line of treatment. Lower family income and peripheral neuropathy may worsen HRQoL. ASCT may improve patients HRQoL and VTd regimen was related with better HRQoL than thalidomide-based regimens. Our results are valuable especially for developing countries, where thalidomide and bortezomib are the most accessible drugs to MM patients.