Quality of Life in High-Risk Myeloma Patients Treated with Allogeneic Hematopoietic Cell Transplantation Followed by Bortezomib Maintenance
Bibliographic record
Abstract
Abstract Purpose. Allogeneic hematopoietic cell transplantation (HCT) is the only curative treatment in multiple myeloma (MM) but is associated with toxicities that impact quality of life (QoL). This study aimed (1) to describe the levels and evolution of QoL scores of newly diagnosed MM patients who received upfront tandem autologous + nonmyeloablative allogeneic HCT, and (2) to evaluate the impact of chronic graft-versus-host disease (cGVHD) on QoL. Methods. After induction and autologous HCT, patients were invited to participate in a prospective phase II study of tandem nonmyeloablative allogeneic HCT followed by bortezomib maintenance for one year. Participants completed questionnaires assessing QoL and cGVHD before allogeneic HCT (T1), then every three months during treatment (T2 to T6) and after treatment cessation (T7 to T10). Results. Thirty-three patients were included. Participants had high levels of QoL at all measurement times. Cognitive functioning and global health status decreased significantly during treatment (T1 vs. T2-T5), while fatigue symptoms were reported more frequently. After treatment cessation (T7-T10), only cognitive functioning remained significantly impacted. In contrast, participants reported a better emotional well-being after transplant (T1 vs. T2, T4-T10). Furthermore, as QoL scores were more frequently associated to lung, energy and psychological cGVHD domains. Conclusion. Our study demonstrates preservation of QoL during this upfront tandem treatment including autologous transplant followed by allogeneic HCT. Some identified domains impacting QoL may support therapeutic actions such as supportive care including psychological and neuropsychological interventions, as well as adapted physical activity in this population. This trial was registered on 01/12/2014 to ClinicalTrial.gov: NCT02308280.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".