title: Prevalence of symptoms in patients with multiple myeloma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Multiple myeloma (MM) is an incurable haematological disease. Due to novel agents, overall survival has improved in this group, yet there are no systematic reviews to understand the symptom profiles resulting from disease and treatment-related toxicities. We aimed to synthesise data on the prevalence of symptoms in patients with MM.
  
  
  METHODS
  A systematic database and grey literature search were conducted in six databases. Random-effects meta-analysis with inverse variance weighting to pool prevalence data was performed.
  
  
  RESULTS
  Thirty-six studies were included of which 34 studies (N = 3023) provided data for meta-analysis. Twenty-seven distinct symptoms were reported, with the majority of studies focusing on pain (n = 27), fatigue (n = 19) and problems with functioning (n = 15). The most prevalent symptoms were fatigue (98.8%, 95% CI 98.1-99.2%), pain (73%, 39.9-91.7), constipation (65.2%, 22.9-92.2) and tingling in the hands/feet with 53.4% (0.4-99.7). The most common problems were decreased physical functioning (98.9%, 98.2-99.3), decreased cognitive functioning (80.2%, 40-96.1) and financial difficulties (78.4%, 39.1-95.4). These problems were present in newly diagnosed to advanced disease stage.
  
  
  CONCLUSIONS
  Optimal quality of life and good symptom management in this incurable disease can only be achieved by routinely assessing symptoms throughout the disease trajectory.
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Faculty of Life Sciences and Medicine, King's College London, London, UK. christina.ramsenthaler@kcl.ac.uk.|Department of Palliative Medicine, Munich University Hospital, Munich, Germany. christina.ramsenthaler@kcl.ac.uk.
authors.forename: Christina
authors.initials: C
authors.lastname: Ramsenthaler
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Pauline
authors.initials: P
authors.lastname: Kane
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Faculty of Life Sciences and Medicine, King's College London, London, UK.|Department of Psychology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Siegert
authors.affiliation: Department of Palliative Care, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Polly M
authors.initials: PM
authors.lastname: Edmonds
authors.affiliation: Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Schey
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Faculty of Life Sciences and Medicine, King's College London, London, UK.
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000453:epidemiology*; D009367:Neoplasm Staging; D015995:Prevalence; D011788:Quality of Life; D063189:Symptom Assessment
keywords: multiple myeloma; prevalence; signs and symptoms; symptom burden; systematic review