Health-related quality of life in multiple myeloma patients receiving high-dose chemotherapy with autologous blood stem-cell support
Health-related quality of life in multiple myeloma patients receiving high-dose chemotherapy with autologous blood stem-cell support
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DOI：
10.1385/mo:18:1:65
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发表时间：
2001-01-01
期刊：
影响因子：
3.4
通讯作者：
Westin, J
中科院分区：
文献类型：
--
作者：
Gulbrandsen, N;Wisloff, F;Westin, J
在一项以人群为基础的研究中，北欧骨髓瘤研究小组发现，在60岁以下的骨髓瘤患者中，大剂量马法兰配合自体血液干细胞支持与传统化疗相比具有生存优势(风险比：1.62；可信区间[CI]1.222-2.15；p=0.001)。试验中采用了EORTC QLQ-C30问卷，对健康相关的生活质量进行了研究。在接受强化治疗的274名患者中，221名(81%)与120名接受常规马法兰-泼尼松治疗的患者中的113名(94%)相比。在治疗之前，两组之间的任何HRQOL评分都没有统计学意义上的差异。诱导化疗开始后1个月，强化治疗组患者的睡眠障碍明显多于对照组。在6个月，相当于大剂量马法兰治疗后的平均52d，强化治疗的患者的总体生活质量、角色和社会功能评分较低，食欲减退的评分也较高。在12个月和24个月时，患者的HRQOL与对照组相似。在36个月时，强化治疗组的疲倦、疼痛、恶心和食欲不振的趋势有所减轻。因此，18个月的存活时间似乎与良好的健康相关生活质量有关。尽管与早期强化化疗阶段相关的HRQOL适度降低，但这种治疗方式必须被视为多发性骨髓瘤护理的重要一步。
In a population-based study, the Nordic Myeloma Study Group found a survival advantage for high-dose melphalan with autologous blood stem-cell support compared to conventional chemotherapy in myeloma patients under 60 yr of age (risk ratio: 1.62; confidence interval [CI] 1.222-2.15; p=0.001). A study of health-related quality of life (HRQoL) was integrated in the trial, using the EORTC QLQ-C30 questionnaire. Of the 274 patients receiving intensive therapy 221 (81%) were compared to 113 (94%) of 120 patients receiving conventional melphalan-prednisone treatment.Prior to treatment, there were no statistically significant differences in any HRQoL score between the two groups. One month after the start of induction chemotherapy, the patients on intensive treatment had more sleep disturbance than the control patients. At 6 mo, corresponding to a mean of 52 d after high-dose melphalan, the patients on intensive treatment had moderately lower scores for global QoL and role and social functioning and there was also a significantly higher score for appetite loss. At 12 and 24 mo, the HRQoL was similar to that of the control patients. At 36 mo, there was a trend toward less fatigue, pain, nausea, and appetite loss in the intensive-treatment group. Thus, the 18 mo of prolonged survival seem to be associated with a good health-related quality of life. Despite the moderate HRQoL reduction associated with the early intensive chemotherapy phase, this treatment modality must be regarded as an important step forward in the care of multiple myeloma.