Health-related quality of life in patients with multiple myeloma - does it matter?

Survival of patients with multiple myeloma (MM) has been extended markedly in the last 15 years and patients living with the disease for 10-15 years are no longer rare. 1 However, in the absence of a curative treat ment, the aim of therapy is to induce an objective response with the expectation that this leads to a prolongation of sur vival and, furthermore, to improve the patients’ quality of life. Myeloma patients experience a variety of disease-relat ed events and symptoms, such as bone destruction leading to pain, height reduction and body shape changes, and bone marrow failure, renal failure, immunodeficiency, as well as the psychosocial burden of a diagnosis of cancer. These aspects may have different importance for the patient in different periods of the disease. Furthermore, therapeutic interventions may produce troublesome side effects and functional impairments. 2 Although prolonga tion of overall survival will always be a main goal of can cer treatment, health-related quality of life (HRQoL) is becoming increasingly important. To illustrate this, the US Food and Drug Administration (FDA) has emphasized HRQoL as an important end-point for approval of new anticancer drugs. 3 HRQoL is a complex and elusive matter and its evalua tion is critically dependent on our tools and how the results are interpreted. Assessing HRQoL introduces the patients’ perspective into the clinical process via standard ized self-reported instruments (questionnaires) that are scored by the patient. It is generally accepted that the patient should be the primary source of information regarding his or her HRQoL, without interpretation of the patient’s response by a clinician or anyone else. 4,5