Effect of thalidomide with melphalan and prednisone on health-related quality of life (HRQoL) in elderly patients with newly diagnosed multiple ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2011-04-07

AUTHORS

Silvia G. R. Verelst, F. Termorshuizen, C. A. Uyl-de Groot, M. R. Schaafsma, A. H. M. Ammerlaan, S. Wittebol, H. A. M. Sinnige, S. Zweegman, M. van Marwijk Kooy, R. van der Griend, H. M. Lokhorst, P. Sonneveld, P. W. Wijermans, Dutch-Belgium Hemato-Oncology Cooperative Group (HOVON)

ABSTRACT

Thalidomide with melphalan/prednisone (MPT) was defined as standard treatment in elderly patients with multiple myeloma (MM) based on five randomized trials. In one of these trials, HOVON49, a prospective health-related quality-of-life (HRQoL) study was initiated in order to assess the impact of thalidomide on QoL. Patients aged >65 years with newly diagnosed MM were randomized to receive melphalan plus prednisone (MP) or MPT, followed by thalidomide maintenance in the MPT arm. Two hundred eighty-four patients were included in this side study (MP, n = 149; MPT n = 135). HRQoL was assessed with the EORTC Core QoL Questionnaire (QLQ-C30) and the myeloma-specific module (QLQ-MY24) at baseline and at predetermined intervals during treatment. The QLQ-C30 subscales physical function (P = 0.044) and constipation (P < 0.001) showed an improvement during induction in favour of the MP arm. During thalidomide maintenance, the scores for the QLQ-MY24 paraesthesia became significantly higher in the MPT arm (P<0.001). The QLQ-C30 subscales pain (P = 0.12), insomnia (P = 0.068), appetite loss (P = 0.074) and the QLQ-MY24 item sick (P = 0.086) scored marginally better during thalidomide maintenance. The overall QoL-scale QLQ-C30-HRQoL showed a significant time trend towards more favourable mean values during protocol treatment without differences between MP and MPT. For the QLQ-C30 subscales emotional function and future perspectives, difference in favour of the MPT arm from the start of treatment was observed (P = 0.018 and P = 0.045, respectively) with no significant ‘time × arm’ interaction, indicating a persistent better patient perspective with MPT treatment. This study shows that the higher frequency of toxicity associated with MPT does not translate into a negative effect on HRQoL and that MPT holds a better patient perspective. More... »

PAGES

1427-1439

Journal

TITLE

Annals of Hematology

ISSUE

12

VOLUME

90

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00277-011-1224-1

DOI

http://dx.doi.org/10.1007/s00277-011-1224-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1027218353

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21472373


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26 schema:description Thalidomide with melphalan/prednisone (MPT) was defined as standard treatment in elderly patients with multiple myeloma (MM) based on five randomized trials. In one of these trials, HOVON49, a prospective health-related quality-of-life (HRQoL) study was initiated in order to assess the impact of thalidomide on QoL. Patients aged >65 years with newly diagnosed MM were randomized to receive melphalan plus prednisone (MP) or MPT, followed by thalidomide maintenance in the MPT arm. Two hundred eighty-four patients were included in this side study (MP, n = 149; MPT n = 135). HRQoL was assessed with the EORTC Core QoL Questionnaire (QLQ-C30) and the myeloma-specific module (QLQ-MY24) at baseline and at predetermined intervals during treatment. The QLQ-C30 subscales physical function (P = 0.044) and constipation (P < 0.001) showed an improvement during induction in favour of the MP arm. During thalidomide maintenance, the scores for the QLQ-MY24 paraesthesia became significantly higher in the MPT arm (P<0.001). The QLQ-C30 subscales pain (P = 0.12), insomnia (P = 0.068), appetite loss (P = 0.074) and the QLQ-MY24 item sick (P = 0.086) scored marginally better during thalidomide maintenance. The overall QoL-scale QLQ-C30-HRQoL showed a significant time trend towards more favourable mean values during protocol treatment without differences between MP and MPT. For the QLQ-C30 subscales emotional function and future perspectives, difference in favour of the MPT arm from the start of treatment was observed (P = 0.018 and P = 0.045, respectively) with no significant ‘time × arm’ interaction, indicating a persistent better patient perspective with MPT treatment. This study shows that the higher frequency of toxicity associated with MPT does not translate into a negative effect on HRQoL and that MPT holds a better patient perspective.
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32 schema:keywords HRQoL
33 MP
34 MP arm
35 MPT
36 MPT arm
37 MPT treatment
38 QLQ-C30
39 QOL questionnaire
40 QoL.
41 analysis
42 appetite loss
43 arm
44 baseline
45 constipation
46 differences
47 effect
48 effect of thalidomide
49 elderly patients
50 emotional function
51 favor
52 favorable mean values
53 frequency
54 function
55 future perspectives
56 health-related quality
57 high frequency
58 impact
59 impact of thalidomide
60 improvement
61 induction
62 insomnia
63 interaction
64 interval
65 items
66 life
67 life studies
68 loss
69 maintenance
70 mean value
71 melphalan
72 melphalan/prednisone
73 module
74 multiple myeloma
75 myeloma
76 myeloma-specific module
77 negative effects
78 order
79 pain
80 paraesthesia
81 patient's perspective
82 patients
83 perspective
84 physical function
85 predetermined intervals
86 prednisone
87 prospective analysis
88 prospective health-related quality
89 protocol treatment
90 quality
91 questionnaire
92 scores
93 side study
94 significant time trend
95 standard treatment
96 start
97 start of treatment
98 study
99 thalidomide
100 thalidomide maintenance
101 time
102 time trends
103 toxicity
104 treatment
105 trends
106 trials
107 values
108 years
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