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The impact of current therapeutic options on the health-related quality of life of patients with relapse/refractory multiple myeloma: a systematic review of clinical studies

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Abstract

Purpose

Patients with relapse and/or refractory multiple myeloma (RRMM) have a high disease burden with poor health-related quality of life (HRQoL) which worsens with each additional relapse. We aimed to review the impact of triplet, doublet, monotherapies, and salvage autologous stem cell transplantation on the HRQoL of RRMM patients.

Methods

We performed a comprehensive literature search of Medline/PubMed, Wiley Cochrane Library, EMBASE, Scopus, CINAHL, and Clinicaltrials.gov to identify clinical studies in RRMM patients with HRQoL as an outcome measure. The ISOQoL and CONSORT-PRO extension guidelines were used to assess the quality of HRQoL reporting. We synthesized the result using a qualitative analysis.

Results

A total of 10,245 RRMM patients enrolled in 28 eligible studies received either a triplet, doublet regimen, monotherapy, or salvage autologous stem cell transplantation. The EORTC QLQ-C30 was the most used questionnaire, and compliance with HRQoL reporting standards is generally poor among studies without an additional HRQoL publication. Most of the current therapeutic options are at best able to maintain HRQoL at baseline but not improve it. The methodological and reporting heterogeneity among the studies complicates generalizations.

Conclusions

Many of the current treatment regimens for RRMM have demonstrated clinical effectiveness in trials. Unlike newly diagnosed MM, these regimens are less likely to result in significant improvement in HRQoL in RRMM. This should be communicated to patients before initiating therapies.

Implications for Cancer Survivors

Individualized therapeutic approach for RRMM should be chosen based on a shared decision-making process that aligns clinical efficacy with patients’ treatment priorities and HRQoL.

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Data availability

Available from the corresponding author on request.

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  1. Department of Internal Medicine, Howard University Hospital, 2041 Georgia Ave. NW, Washington, DC, USA

    Ademola S. Ojo

  2. Hematology/Oncology Division, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Mojisola O. Araoye

  3. Department of Medicine, Hematology/Oncology Division, Howard University Hospital, Washington, DC, USA

    Ahmed Ali & Ravi Sarma

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Ademola Ojo: conceptualization, data curation, writing-original draft preparation. Mojisola Araoye: data curation, writing-reviewing and editing. Ahmed Ali: writing-reviewing and editing. Ravi Sarma: writing-reviewing and editing, supervision.

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Multiple myeloma OR myeloma

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Relapse OR refractory OR relapse and/or refractory OR relapse and refractory

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Quality of life OR health related quality of life OR patient reported outcomes OR health outcomes OR physical functioning OR patient outcomes

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("multiple myeloma"[MeSH Terms] OR ("multiple"[All Fields] AND "myeloma"[All Fields]) OR "multiple myeloma"[All Fields] OR "myeloma"[All Fields] OR "myelomas"[All Fields] OR "myeloma s"[All Fields]) AND ("recurrence"[MeSH Terms] OR "recurrence"[All Fields] OR "relapse"[All Fields] OR "relapses"[All Fields] OR "relapsing"[All Fields] OR "relapsed"[All Fields] OR "relapser"[All Fields] OR "relapsers"[All Fields]) AND ("quality of life"[MeSH Terms] OR ("quality"[All Fields] AND "life"[All Fields]) OR "quality of life"[All Fields])

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Ojo, A.S., Araoye, M.O., Ali, A. et al. The impact of current therapeutic options on the health-related quality of life of patients with relapse/refractory multiple myeloma: a systematic review of clinical studies. J Cancer Surviv 18, 673–697 (2024). https://doi.org/10.1007/s11764-023-01332-1

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