Real-World Evaluation of Health-Related Quality of Life in Patients With Multiple Myeloma From Germany

Engelhardt, Monika; Ihorst, Gabriele; Singh, Moushmi; Rieth, Achim; Saba, G.; Pellan, Marine; Lebioda, A.

doi:10.1016/j.clml.2020.10.002

Cited by 45 publications

(42 citation statements)

References 34 publications

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“…After a treatment-free interval of >24 months, disease-free patients appear to have recovered a large portion of the HRQoL lost during treatment and just after its cessation. A similar effect of treatment on HRQoL and post-treatment recovery has previously been reported in patients with acute myeloid leukemia [30] and in real-world studies of French [24] and German patients [26] with multiple myeloma. In adults with ALL, the presence of MRD is widely recognized as the most sensitive prognostic factor for relapse and death regardless of treatment choice and risk classification [14].…”

Section: Discussionsupporting

confidence: 81%

“…Treatment line and response to treatment both had an impact on HRQoL. For example, a close relationship between multiple lines of therapy and HRQoL deterioration has previously been observed in real-world studies of French [24], Spanish [25], and German [26] patients with multiple myeloma. Indeed, the health of patients with relapsed/refractory disease is compromised by the highly toxic multidrug salvage chemotherapy regimens that are commonly used.…”

Section: Discussionmentioning

confidence: 70%

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Quality of life in adults with acute lymphoblastic leukemia in France: results from a French cross-sectional study

Leprêtre

Touboul²,

Flinois³

et al. 2021

Leukemia & Lymphoma

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In recent years, treatment of acute lymphoblastic leukemia (ALL) has improved substantially, leading to longer survival. This has necessitated a greater focus on health-related quality of life (HRQoL), but data are lacking. In a part-prospective, part-retrospective study, we enrolled 219 adults with ALL in France to assess the impact of key disease and treatment characteristics on HRQoL. Overall HRQoL and most specific QoL domain scores were consistently better among patients receiving front-line therapy, those currently in complete remission, and those who had previously received hematopoietic stem-cell transplantation. Furthermore, HRQoL was consistently impaired in patients with minimal residual disease present (MRDþ). In multivariate analyses, multiple lines of therapy, MRDþ, leukopenia, comorbidities, and anemia were significantly associated with impaired HRQoL. This study provides real-world data on HRQoL in adults with ALL in France and shows the positive impact of MRD-negative status on HRQoL.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 70%

Quality of life in adults with acute lymphoblastic leukemia in France: results from a French cross-sectional study

Leprêtre

Touboul²,

Flinois³

et al. 2021

Leukemia & Lymphoma

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“…Transplantation at 1L also appears to influence subsequent treatment choices: triplet regimens were more frequently prescribed to patients who received an ASCT at 1L than to those who did not. Studies have shown that younger patients, with fewer comorbidities, are likely to tolerate more lines of treatment (including ASCT) and more aggressive regimens [ 1 , 22 , 34 , 35 ]. Access to and reimbursement of treatments also influences treatment patterns [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Survival and treatment patterns of patients with relapsed or refractory multiple myeloma in France — a cohort study using the French National Healthcare database (SNDS)

et al. 2021

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Over the past decade, several drugs have been approved for the treatment of relapsed or refractory multiple myeloma (RRMM). This retrospective study, using the French National Healthcare database (SNDS), describes the treatment patterns and outcomes of patients with RRMM treated in real-world clinical practice in France. Patients were adults, with a diagnosis of multiple myeloma, who initiated second-line (2L) treatment approved for use in France between 2014 and 2018; this included bortezomib, carfilzomib, daratumumab, ixazomib, lenalidomide, or pomalidomide. Data were analyzed overall, by first-line (1L) autologous stem cell transplant (ASCT) status and by lenalidomide treatment status at 2L. In total, 12987 patients with RRMM were included in the study (mean age 69.5 years); 27% received an ASCT at 1L, and 30% received a lenalidomide-sparing regimen at 2L. Overall, and among the ASCT and non-ASCT subgroups, most patients received a bortezomib-based regimen at 1L, whereas lenalidomide-based regimens were most common at 2L. Among patients who received a lenalidomide-sparing regimen at 2L, this was most often a proteasome inhibitor-based regimen. Mortality rate was 26.1/100 person-years, and median (95% confidence interval) survival from 2L initiation was 32.4 (31.2–33.6) months. Survival differed by various factors, shorter survival was reported in the non-ASCT group, those receiving a lenalidomide-sparing regimen at 2L, older patients (≥ 70 years), and those with multiple comorbidities. This analysis provides insight into the real-world use of approved novel MM treatments and highlights an ongoing unmet need to improve outcomes, particularly for selected patient groups.

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“…Therefore, it is important to assess frailty and comorbidities over the disease course in MM tumor boards regularly and if new treatment decisions are being undertaken [6,[44][45][46][47][48]. The assessment of changing performance status over the disease course was described by us in a reference AL-amyloidosis patient [46], in allogeneic stem cell transplantation-receiving MM patients [47], likewise in ASCT-receiving MM patients [48] and with use of quality of life (QoL) tests in various relapse phases [49]. All of these manuscripts verify that functional performance may change over time and is relevant for treatment decisions.…”

Section: Figurementioning

confidence: 99%

Choosing the Right Therapy for Patients with Relapsed/Refractory Multiple Myeloma (RRMM) in Consideration of Patient-, Disease- and Treatment-Related Factors

Gengenbach

Graziani

Reinhardt

et al. 2021

Cancers

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Treatment of relapsed/refractory multiple myeloma (RRMM) is more complex today due to the availability of novel therapeutic options, mostly applied as combination regimens. immunotherapy options have especially increased substantially, likewise the understanding that patient-, disease- and treatment-related factors should be considered at all stages of the disease. RRMM is based on definitions of the international myeloma working group (IMWG) and includes biochemical progression, such as paraprotein increase, or symptomatic relapse with CRAB criteria (hypercalcemia, renal impairment, anemia, bone lesions). When choosing RRMM-treatment, the biochemical markers for progression and severity of the disease, dynamic of disease relapse, type and number of prior therapy lines, including toxicity and underlying health status, need to be considered, and shared decision making should be pursued. Objectively characterizing health status via geriatric assessment (GA) at each multiple myeloma (MM) treatment decision point has been shown to be a better estimate than via age and comorbidities alone. The well-established national comprehensive cancer network, IMWG, European myeloma network and other national treatment algorithms consider these issues. Ideally, GA-based clinical trials should be supported in the future to choose wisely and efficaciously from available intervention and treatment options in often-older MM adults in order to further improve morbidity and mortality.

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Real-World Evaluation of Health-Related Quality of Life in Patients With Multiple Myeloma From Germany

Cited by 45 publications

References 34 publications

Quality of life in adults with acute lymphoblastic leukemia in France: results from a French cross-sectional study

Quality of life in adults with acute lymphoblastic leukemia in France: results from a French cross-sectional study

Survival and treatment patterns of patients with relapsed or refractory multiple myeloma in France — a cohort study using the French National Healthcare database (SNDS)

Choosing the Right Therapy for Patients with Relapsed/Refractory Multiple Myeloma (RRMM) in Consideration of Patient-, Disease- and Treatment-Related Factors

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