Ohio State University Wexner Medical Center, Columbus, OH
Geetika Bhatt , Don M. Benson Jr., Yvonne Adeduni Efebera , Craig C. Hofmeister , Samantha Mary Jaglowski , Steven Michael Devine , Tanya Marya Wildes , Ying Huang , Desiree Jones , Ashley Elizabeth Rosko
Background: Patients with Multiple Myeloma (MM) report some of the poorest Health-related quality of life (HRQoL). Few studies show how ASCT influences global health outcomes as measured by a Geriatric Assessment (GA). We performed a prospective GA evaluating the dynamic changes in health pre- and post-ASCT. Methods: 100 pts with plasma cell dyscrasia (median (m) = 60 yrs, range (r) = 36-75 yrs) underwent GA pre-ASCT, 90 days and 1-yr post-ASCT. GA included nutritional survey, Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), Medical Outcomes Study-Social Support Survey (MOS-SSS), Short Physical Performance Battery (SPPB), handgrip strength, self-reported Human Activity Profile (HAP) Maximum Activity Score (MAS) and Adjusted Activity Score (AAS). Data were analyzed using paired t-test (p < 0.05). Results: Pts reported moderate fatigue pre-ASCT (m = 4.6, r: 0-9.8) which normalized at 1-yr (m = 2.5, r: 0-7.3; p = 0.008). Self-reported pre-ASCT physical function (MAS) (m = 73, r = 20-94) improved at 1-yr (m = 75.5, r = 52-94; p = 0.014); AAS (m = 64, r = 18-94) also improved at 1-yr (m = 70.5, r = 38-91; p = 0.025). In contrast, MD-reported KPS decreased. Screens for deficits in anxiety, depression, social support, objective physical function, handgrip strength and wt loss did not change significantly at 1-yr. Conclusions: Our data indicate that ASCT significantly improves patient-reported fatigue and physical function, unlike MD-reported KPS.
DOMAINS | PRE-ASCT (n = 100) | PRE VS 90-DAY POST-ASCT (n = 36) | PRE VS. 365-DAY POST-ASCT (n = 36) | |||
---|---|---|---|---|---|---|
M (r) | M (r) | p value | M (r) | p value | ||
Hospital Anxiety and Depression Scale | 11 (1-29) | 9 (0-22) | 0.93 | 7.5 (0-24) | 0.06 | |
Brief Fatigue Inventory | 4.61 (0-9.78) | 2.67 (0-7.4) | 0.03 | 2.5 (0-7.33) | 0.008 | |
Social Support (MOS-SSS) | 83 (31-95) | 83.5 (33-95) | 0.31 | 84.5 (25-95) | 0.44 | |
Self-Reported activity | Maximum Activity Score | 73 (20-94) | 68 (45-91) | 0.78 | 75.5 (52-94) | 0.014 |
Adjusted Activity Score | 64 (18-94) | 62.5 (28-91) | 0.81 | 70.5 (38-91) | 0.025 | |
Objective Physical Function | Short Physical Performance Battery | 10 (4-12) | 11 (1-12) | 0.38 | 10 (6-12) | 0.78 |
Dominant handgrip strength | 31 (10-72) | 30 (8-72) | 0.2 | 30.5 (12-92) | 0.45 | |
Performance Status (%) | 90 (70-100) | 80 (70-100) | 0.002 | 80 (70-100) | 0.03 |
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