Journal
BRITISH JOURNAL OF HAEMATOLOGY
Volume 182, Issue 6, Pages 816-829Publisher
WILEY
DOI: 10.1111/bjh.15459
Keywords
multiple myeloma; quality of life; EORTC QLQ-C30; EORTC MY-24; immunomodulatory agent
Categories
Funding
- MRC Leukaemia Data Monitoring and Ethics Committee
- MRC Leukaemia Trial Steering Committee
- UK National Cancer Research Institute Haematological Oncology Clinical Studies Group
- Myeloma UK
- National Institute for Health Research through the National Cancer Research Network
- Medical Research Council (London, UK) [G0100132]
- Novartis
- Schering Health Care
- Chugai
- Pharmion
- Celgene Corporation
- Ortho Biotech
- MRC [G0100132] Funding Source: UKRI
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In the Medical Research Council (MRC) Myeloma IX trial (ISRCTN684564111) patients were randomised to sodium clodronate or zoledronic acid and induction treatment: cyclophosphamide, vincristine, doxorubicin and dexamethasone (CVAD) or cyclophosphamide, thalidomide and dexamethasone (CTD) followed by autologous stem cell transplant (ASCT) in the intensive pathway; attenuated CTD or melphalan and prednisolone (MP) in the non-intensive pathway. Subsequent randomisation allocated patients to either thalidomide or observation. The European Organisation for Research and Treatment of Cancer (EORTC) quality of life (QoL) questionnaires, QLQ-C30 and QLQ-MY24, were administered at baseline, 3, 6 and 12 months and annually thereafter, enabling the effect of sequential treatment on patient-reported health-related QoL (HR-QoL) to be investigated. The protocol specified four subscales of interest: Pain, Fatigue, Global Health Status/Quality of Life and Physical Functioning at 3, 6 and 12 months that were compared using linear models. The intensive pathway showed significant differences in favour of CTD for Fatigue at 3 months and Physical Functioning at 12 months. The non-intensive pathway and maintenance phase reported significant differences at 3 months; Pain (improved with attenuated CTD) and Global Health status/Quality of Life (improved with observation). The improved outcomes in MRC Myeloma IX were accompanied by some beneficial and few detrimental effects on HR-QoL.
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