Trajectories of quality of life recovery and symptom burden after autologous hematopoietic cell transplantation in multiple myeloma

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...

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Published in:American journal of hematology 2023-01, Vol.98 (1), p.140-147
Main Authors: D'Souza, Anita, Brazauskas, Ruta, Stadtmauer, Edward A., Pasquini, Marcelo C., Hari, Parameswaran, Bashey, Asad, Callander, Natalie, Devine, Steven, Efebera, Yvonne, Ganguly, Siddhartha, Gasparetto, Cristina, Geller, Nancy, Horowitz, Mary M., Koreth, John, Landau, Heather, Brunstein, Claudio, McCarthy, Philip, Qazilbash, Muzaffar H., Giralt, Sergio, Krishnan, Amrita, Flynn, Kathryn E.
Format: Article
Language:English
Subjects:
Autografts
Disease control
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Middle Aged
Multiple myeloma
Multiple Myeloma - therapy
Quality of Life
Stem cell transplantation
Transplantation
Transplantation, Autologous
Transplants & implants
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Summary: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 
ISSN:0361-8609
1096-8652
1096-8652
DOI:10.1002/ajh.26596