Supportive Care in Cancer

, Volume 11, Issue 9, pp 568–574

Use of a supportive care team for screening and preemptive intervention among multiple myeloma patients receiving stem cell transplantation

  • Allen C Sherman
  • Elizabeth Ann Coleman
  • Kathleen Griffith
  • Stephanie Simonton
  • R. Jean Hine
  • Jeana Cromer
  • Umaira Latif
  • Harriet Farley
  • Rowena Garcia
  • Elias J. Anaissie
Original Article

DOI: 10.1007/s00520-003-0464-6

Cite this article as:
Sherman, A.C., Coleman, E.A., Griffith, K. et al. Support Care Cancer (2003) 11: 568. doi:10.1007/s00520-003-0464-6

Abstract

Although peripheral blood stem-cell transplantation (PBSCT) has assumed a growing role in the treatment of multiple myeloma, very few studies have examined the functional and quality-of-life changes experienced by myeloma patients in the transplant setting. Multiple myeloma is characterized by a range of debilitating physical and psychosocial symptoms. However, supportive care needs for patients with this disease are often overlooked or managed only episodically. The current study pilot-tested an interdisciplinary supportive care program designed to provide screening and identify patients at risk early in the course of care. Participants in this pilot project were 61 patients with hematological disorders, predominantly multiple myeloma (85.3%), evaluated during their initial workup. Mean time since diagnosis was 7.4 months. Participants were interviewed by an advanced-practice nurse and completed standardized measures of heath-related quality of life (SF-12), fatigue (POMS-Fatigue), nutritional risk (PG-SGA), pain (Brief Pain Inventory), emotional functioning (Hospital Anxiety and Depression Scale), and sexual concerns (FACIT). Results indicated that difficulties were prevalent across multiple functional domains; 61.4% of patients displayed significant nutritional deficits. Physical functioning was below age-adjusted national norms for 53.5%. Moderate-to-severe fatigue was reported by 39.0%, and one third experienced clinically significant levels of pain, impaired daily functioning associated with pain, and emotional distress. A similar proportion of respondents (33.9%) reported disrupted sexual functioning and difficulty with body image. Findings suggest that early, systematic screening is feasible in a busy transplant center. The prevalence of symptoms highlights the importance of providing screening and proactive intervention for multiple myeloma patients early in the course of treatment and even prior to beginning protocols for high-dose therapy and transplantation.

Keywords

Quality of lifeSupportive careMultiple myelomaAutologous stem cell transplantation

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Allen C Sherman
    • 1
  • Elizabeth Ann Coleman
    • 2
  • Kathleen Griffith
    • 3
  • Stephanie Simonton
    • 1
  • R. Jean Hine
    • 4
  • Jeana Cromer
    • 5
  • Umaira Latif
    • 1
  • Harriet Farley
    • 6
  • Rowena Garcia
    • 7
  • Elias J. Anaissie
    • 8
  1. 1.Behavioral MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.College of NursingUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.School of NursingUniversity of MarylandCollege ParkUSA
  4. 4.Department of Dietetics and NutritionUniversity of Arkansas for Medical SciencesLittle RockUSA
  5. 5.Department of Hematology/OncologySt. Jude Children's Research HospitalMemphisUSA
  6. 6.Social WorkUniversity of Arkansas for Medical SciencesLittle RockUSA
  7. 7.Department of AnesthesiologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  8. 8.Myeloma Institute for Research and TherapyUniversity of Arkansas for Medical SciencesLittle RockUSA