Health-related quality of life (HRQL) has become an important outcome measurement in hematology. Our aim was to validate the quality of life questionnaire (QLQ)-MY20 instrument in patients with multiple myeloma (MM) in Mexico. The Mexican-Spanish versions of the QLQ-C30 and QLQ-MY20 instruments were applied to patients with MM at a cancer referral centre. Reliability and validity tests were performed. Test-retest was carried out in selected patients. Ninety-eight patients with MM were included in this study. Questionnaire compliance rates were high, and the instrument was well accepted; internal consistency tests demonstrated good convergent and divergent validity. Cronbach's α coefficients of seven of nine multi-item scales of the QLQ-C30 and of all three multi-item scales of the QLQ-MY20 instruments were >0.7 (range, 0.36-0.89). The scales of the QLQ-C30 and QLQ-MY20 instruments distinguished among clinically distinct groups of patients; 9 of 15 scales of the QLQ-C30 and all 4 scales of the QLQ-MY20 presented responsiveness after change over time. The Mexican-Spanish version of the QLQ-MY20 questionnaire is reliable and valid for the assessment of HRQL in patients with MM and can be used in clinical trials in the Mexican community.
Objective
Vertebroplasty is a percutaneous minimally invasive procedure indicated for vertebral collapse pain treatment. Among the known complications of the procedure is the augmented risk of new vertebral fractures. There are no specific studies in this patient population describing the risk of new vertebral fractures after vertebroplasty. This study analyzed risk factors associated with new vertebral fractures after vertebroplasty in patients with multiple myeloma.
Methods
Observational retrospective study in patients with multiple myeloma. The data collection took place from January 1, 2010, to December 30, 2017, at the National Cancer Institute. Clinical data and procedural variables such as cement volume, cement leaks, fracture level, number of treated vertebrae, pedicular disease, and cement distribution pattern, with two years follow-up, were analyzed with the Wilcoxon test, and a logistic regression model was used to identify risk factors related to new vertebral fractures. A confidence interval of 95% was used for analysis.
Results
At one-year follow-up, 30% of fractures were reported after vertebroplasty, most of them at low thoracic and lumbar level (50% adjacent level). Vertebroplasty was most commonly performed at the thoracolumbar and lumbar area. We demonstrated a 70.7% median numerical rating scale reduction at one-year follow-up; a significant decrease in opioid consumption occurred only during the first month.
Conclusions
Pedicle involvement, disc leakage, cement volume, thoracolumbar and lumbar level, and number of treated vertebrae by intervention are important risk factors when performing vertebroplasty. Prospective randomized studies are needed to evaluate these factors in this specific population.
Introduction: Although multiple myeloma (MM) represents only 1% of the global burden of cancer, its prevalence increases as the population ages. Monitoring our progress to treat MM requires novel tools for epidemiologic surveillance. Methods: We developed a surrogate measure for the burden of MM in Mexico during 2015, representing the number of prevalent and incident cases of MM at every public and private Mexican health institution. We identified individuals through the ICD-10 codes C90.0-C90.3. Hospitalizations and mortality due to MM were also studied. The number of cases was standardized to represent the age-specific Mexican population obtained through census data. We conducted structured interviews to clini-cians to gather data on treatment and clinical characteristics. Results: In 2015, 2569 patients with MM were attended, 2039 unique patients were hospitalized, and 1169 patients died in the Mexican health system. The incidence rate for MM was 1.16 × 100,000 inhabitants-year during the study period. Therapies were consistent between the public and private sectors. Incidence was higher among elder men. Conclusion: Our findings align with epidemiologic trends in the developing world. As we face aging of the population and new therapies extend the survival of patients with MM, our surrogate will be useful for epidemiologic surveillance.
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