A systematic review of health-related quality of life in longitudinal studies of myeloma patients.
OBJECTIVE
Multiple myeloma (MM) patients report high symptom burden and reduced health-related quality of life (HRQoL) compared to patients with other haematological malignancies. The aim of this review was to analyse published longitudinal studies including MM patients according to a change in HRQoL scores, which is perceived as beneficial to the patient according to two published guidelines.


METHODS
A literature search was performed May 2016. Publications with longitudinal follow-up using the EORTC QLQ-C30 instrument for HRQoL measurement of physical functioning, global quality of life, fatigue and/or pain were included. An analysis of mean change from baseline was carried out according to minimal important difference (MID).


RESULTS
Large and medium HRQoL improvements were reported during first-line treatments. No clinically beneficial change or deteriorations in scores of global QoL or fatigue were reported during relapse treatment. HRQoL data during maintenance therapy are sparse and inconclusive.


CONCLUSIONS
Guidelines for interpreting changes in HRQoL including definitions of MID have been developed; however, consensus is missing. Improvements in HRQoL are far more likely to occur during first-line compared to relapsed treatment regimens. The background of these findings should be in focus in future studies, and HRQoL measurements should be integrated in maintenance studies.
Quality of Life Research Centre, Department of Haematology, Odense University Hospital, Odense, Denmark.|The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
Lene Kongsgaard
http://orcid.org/0000-0003-2083-3870
LK
Nielsen
University Hospitals Centre for Health Research, Copenhagen University Hospital, Copenhagen, Denmark.
Mary
M
Jarden
Department of Haematology, Roskilde University Hospital, Roskilde, Denmark.
Christen Lykkegaard
CL
Andersen
Quality of Life Research Centre, Department of Haematology, Odense University Hospital, Odense, Denmark.|The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
Henrik
H
Frederiksen
Quality of Life Research Centre, Department of Haematology, Odense University Hospital, Odense, Denmark.|The Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark.
Niels
N
Abildgaard
D000818:Animals; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D019983:Guideline Adherence; D006801:Humans; D008137:Longitudinal Studies; D009101:Multiple Myeloma / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome
Health-related quality of life; longitudinal studies; multiple myeloma