Geriatric-assessment-identified functional deficits among adults with multiple myeloma with normal performance status

Jensen, Christopher E.; Vohra, Sanah; Nyrop, Kirsten A.; Deal, Allison M.; Muss, Hyman B.; Lichtman, Eben I.; Rubinstein, Samuel M.; Wood, William A.; Mangieri, Nicholas J.; Jamison, Lee; Grant, Shakira J.; Tuchman, Sascha A.

doi:10.1016/j.jgo.2021.08.004

Cited by 18 publications

(11 citation statements)

References 51 publications

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“… 15 Prior studies have indicated that routine assessments of performance status do not adequately evaluate for the presence of important functional deficits, particularly among older adults. 16 , 17 Therefore, guidelines from professional organizations including the National Comprehensive Cancer Network and the International Society of Geriatric Oncology advocate for incorporating more comprehensive evaluations into oncology practice, with Geriatric Assessment (GA) methodologies generally highlighted as an optimal approach. 18-21 These assessments consist of evaluations of the older adult’s physical capabilities, function, nutrition, comorbidities, cognition, and psychosocial status.…”

Section: Introductionmentioning

confidence: 99%

Physical Function, Psychosocial Status, and Symptom Burden Among Adults with Plasma Cell Disorders and Associations with Quality of Life

et al. 2022

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Background The plasma cell disorders (PCDs), multiple myeloma (MM), and light-chain amyloidosis (AL) are disproportionately diseases of older adults, whose care may be complicated by frailty associated with advancing age. We sought to evaluate the prevalence of functional deficits and symptoms in a cohort of persons with PCDs and associations of demographic, disease-related, functional, and psychosocial measures with quality of life (QoL). Patients and Methods Adults with PCDs were recruited into an observational registry in 2018-2020. Patients completed a functional assessment and European Organization for Research and Treatment of Cancer QoL questionnaire (QLQ-C30). Associations of covariates of interest with QoL were evaluated via univariate linear regression. Results Among 121 adults, the mean age was 68.6. Diagnoses were 74% MM, 14% AL, 7% both MM and AL, and 5% other PCDs. The median time from diagnosis was 34.9 months. Median lines of therapy were 2, with 11% having received ≥4th-line therapy. Patients with functional deficits had lower mean QoL scores: dependence in IADLs (66.3 vs. 79.9, P = .001) and recent falls (56.7 vs. 76.8, P = .001). Patients ≤6 months from diagnosis had lower QoL (66.7) than those ≥2 years from diagnosis (77.3, P = .03). However, patients on later lines of therapy (≥4th-line) had lower QoL (62.2) than those on 1st-line treatment (76.0, P = .04). Conclusions Patients with physical impairments and more advanced PCDs had lower QoL than those without deficits or earlier in their disease course. Early identification of physical impairments may facilitate interventions that mitigate these deficits and thereby improve QoL for patients with PCDs.

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Section: Introductionmentioning

confidence: 99%

Physical Function, Psychosocial Status, and Symptom Burden Among Adults with Plasma Cell Disorders and Associations with Quality of Life

et al. 2022

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“…The 3-year OS rates of the 3 groups were 84%, 76% and 57%, respectively [5]. In addition, GA score system could also indicate the incidence of treatment-related toxic reactions, so it could provide certain reference information for the choice of treatment regimen for newly diagnosed MM patients [13,[17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Low Barthel index score is a poor prognostic factor for newly diagnosed multiple myeloma patients

et al. 2023

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Background: The basic activities of daily life may affect the prognosis of multiple myeloma (MM) patients and the Barthel index (BI) is currently the most widely used tool to evaluate basic activities of daily life, but few studies have evaluated its prognostic value in MM. Methods: We retrospectively enrolled patients with newly diagnosed MM and analyzed the association between the BI and the survival of newly diagnosed MM patients.Results: We totally analyzed 538 patients and found that median overall survival (OS) and progressionfree survival (PFS) were signi cantly shorter in the low BI (≤85) group compared with the high BI (>85) group. Univariate Cox proportional hazards regression analysis showed that the low BI was associated with shorter OS and PFS. It was also con rmed that the low BI was poor prognostic factor for OS and PFS in multivariable analyses. In the propensity score matching analysis, patients with low BI also had shorter OS and PFS.Conclusion: Our study suggested that the low BI was a poor prognostic factor for patients with newly diagnosed MM.

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“…Considering that the median age at diagnosis for MM is 69 years, 1,2 the compounding effects of age‐related declines in physical function and the presence of complex medical comorbidities can be further exacerbated by MM and its treatments 1,2,5–8 . These cumulative effects contribute to those with MM having the poorest baseline health‐related quality of life (HRQoL) of all cancers 9–12 .…”

Section: Introductionmentioning

confidence: 99%

“…4 Considering that the median age at diagnosis for MM is 69 years, 1,2 the compounding effects of age-related declines in physical function and the presence of complex medical comorbidities can be further exacerbated by MM and its treatments. 1,2,[5][6][7][8] These cumulative effects contribute to those with MM having the poorest baseline healthrelated quality of life (HRQoL) of all cancers. [9][10][11][12] The predilection of MM for older and Black/AA adults means that the compounding effects of age and race could potentially worsen individual health outcomes.…”

Section: Introductionmentioning

confidence: 99%

“A lot to manage and still have some kind of a life”: How multiple myeloma impacts the function and quality‐of‐life of Black–White patient–caregiver dyads

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Mills

Mihas

et al. 2023

J American Geriatrics Society

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BackgroundMultiple myeloma (MM) is an incurable debilitating blood cancer associated with the lowest health related quality of life (HRQoL) of all cancers. With nearly 88% of adults aged ≥55 years at diagnosis, age‐associated physical losses, comorbidities, and social factors contribute to worsening HRQoL. This qualitative study assessed dyadic (patient–informal caregiver) perspectives on the factors contributing to HRQoL in MM survivors.MethodsWe recruited 21 dyads from the UNC‐Chapel Hill Lineberger Comprehensive Cancer between 11/2021 and 04/2022. Participants completed a single dyadic semistructured interview capturing broad perspectives on MM. We used ATLAS. ti v 9 for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk, Inc.). This iterative approach allowed the exploration and identification of themes within and across transcripts.ResultsThe mean age at enrollment was 71 years (median: 71, range: 57–90) for patients and 68 years (median 67, range: 37–88) for caregivers. All dyads were racially concordant (11 Black/AA and 10 White). However, we aggregated the findings due to no consistent racial differences. Six themes related to (1) physical burden, (2) treatment challenges, (3) losses of independence, (4) caregiver burden, (5) patient and caregiver perseverance, and (6) adjustment to a new normal were identified. Dyads also experienced MM together, resulting in patients and caregivers experiencing changes in their ability to engage in physical and social activities, which further contributed to poor HRQoL. Patients' increased need for social support led to shifts in the caregiver roles, resulting in caregivers feeling burdened by their responsibilities. All dyads acknowledged the need for perseverance and adaptability to a new normal with MM.ConclusionThe functional, psychosocial, and HRQoL of older patients with MM and their caregivers remain impacted ≥6 months after a new diagnosis highlighting clinical and research opportunities to focus on preserving or improving the health of dyads living with MM.

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Geriatric-assessment-identified functional deficits among adults with multiple myeloma with normal performance status

Cited by 18 publications

References 51 publications

Physical Function, Psychosocial Status, and Symptom Burden Among Adults with Plasma Cell Disorders and Associations with Quality of Life

Physical Function, Psychosocial Status, and Symptom Burden Among Adults with Plasma Cell Disorders and Associations with Quality of Life

Low Barthel index score is a poor prognostic factor for newly diagnosed multiple myeloma patients

“A lot to manage and still have some kind of a life”: How multiple myeloma impacts the function and quality‐of‐life of Black–White patient–caregiver dyads

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