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Table of Contents
LETTER TO EDITOR
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 131

Quality of life in patients with multiple myeloma


Department of Medical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India

Date of Web Publication9-Sep-2019

Correspondence Address:
Avinash Bonda
Department of Medical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_33_19

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How to cite this article:
Bonda A. Quality of life in patients with multiple myeloma. Cancer Res Stat Treat 2019;2:131

How to cite this URL:
Bonda A. Quality of life in patients with multiple myeloma. Cancer Res Stat Treat [serial online] 2019 [cited 2019 Nov 13];2:131. Available from: http://www.crstonline.com/text.asp?2019/2/1/131/266455



Dear Editor,

Multiple myeloma (MM) is a common hematological malignancy in India. With the advent of novel therapies and increased use of high-dose chemotherapy with autologous stem cell transplant, the survival of patients with myeloma has significantly improved.[1] The aims of MM treatment are to control disease, prolong survival, and maximize patient well-being. Despite the considerable improvements in the treatment, many MM patients will experience multiple subsequent relapses of their disease requiring subsequent treatment. While MM has no cure, successive lines of treatment can lead to a greater risk of developing adverse reactions that could be, in turn, responsible for the sequelae and create handicaps impacting patients' quality of life. Health-related quality-of-life (HRQoL) instruments can be incorporated into clinical studies to get a more comprehensive evaluation of treatment outcomes. The data on HRQoL in the Indian scenario are sparse.

The current study by Raghavan et al. is an important effort.[2] The capture of Indian data in the era of novel agents in a rural set up is a well-conceived notion.

HRQoL assessment is dynamic in chronic diseases such as myeloma. The origin of treatment, disease control, symptomatic improvement, and toxicities influences the QoL in a continuous manner. Despite a cross-sectional design with a limited sample size, the study managed to capture the most important functional scores and the symptom burden. The chemotherapy regimens comprised predominantly melphalan/prednisolone/thalidomide and lenalidomide/dexamethasone (Rd) – which are mostly used in transplant ineligible patients. Accordingly, the representation of an autologous transplant was also less (5%) given the resource-constrained settings in our country. Autologous transplant in myeloma is an indispensable treatment modality with a significant improvement in QoL with respect to the time without investigations, symptoms, treatment, and toxicities. The impact of autologous transplant in myeloma-related QoL needs to be studied in the current setting. The study also pointed out an important observation regarding the cost of the treatment – financial burden/strain in more than half of the population. In a government setup without transplant, this is definitely high and perhaps needs a detailed analysis to identify the costs of evaluation, treatment, and the management of toxicities to optimize them. The disease in itself has a relapsing-remitting course and so its effect on HRQoL. The capture of these measures during relapse and re-treatment with due importance to the costs of retreatment and its tolerance would be an important goal in these types of studies. Hence, a dynamic and prospective assessment of HRQoL in myeloma patients with due incorporation of the financial aspects of treatment in a resource-constrained setting like ours is the need of the hour.



 
  References Top

1.
Bagal B, Bonda A. Induction therapy in newly diagnosed multiple myeloma: Current research scenario and questions for the future. Cancer Res Stat Treat 2019;2:76-82.  Back to cited text no. 1
  [Full text]  
2.
Raghavan V, Manuprasad A, Sajeev Kumar PB, Raj Z, Shenoy PK, Nair CK. Health-related quality of life in patients with multiple myeloma on novel agents: Report from a tertiary cancer center in rural India. Cancer Res Stat Treat 2018;1:92-5.  Back to cited text no. 2
  [Full text]  




 

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