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

Abstract

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.

Original Paper Optimizing individualized therapy decision-making in multiple myeloma (MM): Integration and impact of the Revised Myeloma Comorbidity Index in the MM-Tumor Board

“…10,13,31 FA have been described as challenging to integrate into everyday clinics due to time constraints. 13,[32][33][34] The pivotal outcome of our study was the successful integration of the R-MCI into MM-TB protocols in > 90%, con rming previous studies of the R-MCI being resourceful. [7][8][9][10]13,14,24,33 The establishment of the R-MCI in our MM-TB exempli ed that frailty scores can be readily used in everyday clinics.…”

“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

“…Our study's findings are especially relevant to older adults, who account for nearly 90% of all newly diagnosed MM cases 3 . Furthermore, at diagnosis, approximately 60% of older adults with MM will have impairments in activities of daily living and instrumental activities of daily living and reduced HRQoL 5,15,16,51 . In our data, we also demonstrate the functional challenges, losses in independence, and difficulty engaging in physical and social activities and the tremendous burdens placed on older adults living with MM.…”

“…3 Furthermore, at diagnosis, approximately 60% of older adults with MM will have impairments in activities of daily living and instrumental activities of daily living and reduced HRQoL. 5,15,16,51 In our data, we also demonstrate the functional challenges, losses in independence, and difficulty engaging in physical and social activities and the tremendous burdens placed on older adults living with MM. The functional and psychosocial impairments reported by study participants further support the need for future intervention studies targeting these domains.…”

Use of Oral Antivirals Ritonavir-Nirmatrelvir and Molnupiravir in Patients with Multiple Myeloma Is Associated with Low Rates of Severe COVID-19: A Single-Center, Prospective Study

“…Regarding PS, a statistically significant difference of mild cases versus severe cases was observed, while the difference between mild and moderate cases was borderline non-significant. The PS of each patient could be affected by age, BMI, comorbidities, antimyeloma therapy, tolerance to this therapy, and severity of the underlying MM [ 29 ]. A longer follow up of our data would enable the characterization of long-term outcomes related to COVID-19, such as the persistence of symptoms related to long COVID.…”