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

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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.

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Acknowledgments

This work was supported by a grant by Ortho-Biotech to the senior author, Dr. Anaissie.

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Authors and Affiliations

  1. Behavioral Medicine, University of Arkansas for Medical Sciences, 4301 West Markham, 756, Little Rock, AR, 72205, USA

    Allen C Sherman, Stephanie Simonton & Umaira Latif

  2. College of Nursing, University of Arkansas for Medical Sciences, 4301 West Markham, 784, Little Rock, AR, 72205, USA

    Elizabeth Ann Coleman

  3. School of Nursing, University of Maryland, College Park, MD, USA

    Kathleen Griffith

  4. Department of Dietetics and Nutrition, University of Arkansas for Medical Sciences, 4301 West Markham, 623, Little Rock, AR, 72205 , USA

    R. Jean Hine

  5. Department of Hematology/Oncology, St. Jude Children's Research Hospital, 332 N Lauderdale, Memphis, TN, 38105, USA

    Jeana Cromer

  6. Social Work, University of Arkansas for Medical Sciences, 4301 West Markham, 721, Little Rock, AR, 72205, USA

    Harriet Farley

  7. Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 West Markham, 515, Little Rock, AR, 72205, USA

    Rowena Garcia

  8. Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, 4301 West Markham, 776, Little Rock, AR, 72205, USA

    Elias J. Anaissie

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  1. Allen C Sherman
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  2. Elizabeth Ann Coleman
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  10. Elias J. Anaissie
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Corresponding author

Correspondence to Allen C Sherman.

Additional information

Based in part on data presented at the 2002 Tandem BMT Meetings of the International Bone Marrow Transplant Registry, Autologous Blood and Marrow Transplant Registry, and American Society of Blood and Marrow Transplantation, Orlando, Florida, USA, February 22, 2002.

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Sherman, A.C., Coleman, E.A., Griffith, K. et al. Use of a supportive care team for screening and preemptive intervention among multiple myeloma patients receiving stem cell transplantation. Support Care Cancer 11, 568–574 (2003). https://doi.org/10.1007/s00520-003-0464-6

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  • DOI: https://doi.org/10.1007/s00520-003-0464-6

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