No Negative Effects on HRQOL With Post-ASCT Maintenance Therapy for Multiple Myeloma

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FACT-MM, BPI, and EQ-5D measures improved in all groups after undergoing ASCT, researchers found.
FACT-MM, BPI, and EQ-5D measures improved in all groups after undergoing ASCT, researchers found.

Maintenance therapy with lenalidomide or any other agent does not negatively affect the health-related quality of life (HRQOL) of patients with multiple myeloma (MM) who have undergone autologous stem cell transplantation (ASCT), according to a study published in the Annals of Hematology.

ASCT is a standard of care among patients with newly diagnosed MM but is not a curative treatment. Although maintenance therapy delays relapse post-ASCT, improves overall survival, and other associated outcomes, its impact on HRQOL requires further investigation.

For this study, researchers analyzed a cohort of patients with MM who underwent ASCT with or without maintenance therapy from the Connect MM Registry, a large, observational, prospective US registry of patients with symptomatic newly diagnosed MM. Patient reported outcome (PRO) measures were assessed using the Functional Assessment of Cancer Therapy-General (FACT-G), FACT-MM, brief pain inventory (BPI), the EuroQoL Research Foundation EQ-5D questionnaires at baseline and quarterly thereafter.

Patients were divided into 3 groups: those who received any maintenance therapy (n=244), those who received only lenalidomide as maintenance therapy (n=169), and those who received no maintenance therapy (n=137). The median follow-up was 39.3 months.

Results showed that there were no significant differences between patients in the maintenance therapy arms compared with patients who did not receive maintenance therapy. There were also no differences in change from pre-ASCT baseline measures between the 3 groups in the EQ-5D overall index, FACT MM Trial Outcomes index, BPI, and myeloma subscale scores.

FACT-MM, BPI, and EQ-5D measures improved in all groups after undergoing ASCT; FACT-MM and BPI decreased with disease progression.

The authors concluded that “continued, active, post-ASCT maintenance therapy does not decrease HRQOL while improving clinical outcomes, thus supporting a favorable benefit–risk profile. Confirmation of these outcomes with a longer follow-up and in the Connect MM Registry Cohort 2 is warranted.”

Reference

Abonour R, Wagner L, Durie BGM, et al. Impact of post-transplantation maintenance therapy on health-related quality of life in patients with multiple myeloma: data from the Connect® MM Registry [published online July 29, 2018]. Ann Hematol. doi: 10.1007/s00277-018-3446-y

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