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Steinbach M, Neupane K, Aziz M, Lee-Smith W, Julian K, Godara A, McClune B, Kelkar AH, Sborov D, Mohyuddin GR. Multiple Myeloma in Young Patients: A Scoping Review. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024; 24:15-22. [PMID: 37722944 DOI: 10.1016/j.clml.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/19/2023] [Accepted: 08/24/2023] [Indexed: 09/20/2023]
Abstract
Data on the disease course, presenting features, outcomes, and prognosis of younger patients with multiple myeloma (MM) are lacking. Younger patients with MM have historically been considered to have better outcomes primarily based on better tolerance of treatment and lack of medical comorbidities, but the specific age range of this population has not been uniformly defined. Given the lack of consistent data reporting in patients considered to be young MM patients, we performed a scoping review to highlight the research currently available to start drawing conclusions about these patients and highlight unmet areas of need to focus on further investigation. We searched Embase, Cochrane Central Register of Controlled Trials, CINAHL Plus, Web of Science, and the OVID version of MEDLINE including broad terms that embody the concept of young patients with MM. Our final review included 201 studies which were then categorized according to age group, number of patients, outcomes, and comparators to older patients, along with location and database when available. We have chosen to categorize 3 age groupings: <50: young adults with MM (YA MM), 50 to 65: mid-life adults with multiple myeloma (ML MM) and 65+: older adults with multiple myeloma (OA MM). This review demonstrates the heterogeneity that exists in defining and describing young patients with MM, highlights the lack of studies specifically addressing the unique needs of younger patients, and emphasizes areas of future research unique to this population.
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Affiliation(s)
- Mary Steinbach
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT.
| | - Karun Neupane
- Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, New York, NY
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo, Toledo, OH
| | - Wade Lee-Smith
- Mulford Health Science Library, University of Toledo, Toledo, OH
| | - Kelley Julian
- Department of Pharmacy, Huntsman Cancer Hospital, Salt Lake City, UT
| | - Amandeep Godara
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | - Brian McClune
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | | | - Douglas Sborov
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | - Ghulam Rehman Mohyuddin
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
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Zeng L, Huang H, Qirong C, Ruan C, Liu Y, An W, Guo Q, Zhou J. Multiple myeloma patients undergoing chemotherapy: Which symptom clusters impact quality of life? J Clin Nurs 2023; 32:7247-7259. [PMID: 37303229 DOI: 10.1111/jocn.16791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
AIMS AND OBJECTIVES To identify symptom clusters and examine their association with health-related quality of life. BACKGROUND Multiple myeloma patients undergoing chemotherapy suffer from disease symptoms and adverse effects during the course of the disease. However, single symptom management has little effect, and symptom management for these patients remains challenging. Symptom clusters open a new perspective and provide important clues for symptom management. DESIGN A cross-sectional study. METHOD Participants were invited to complete the Chinese version of the Memorial Symptom Assessment Scale and Quality of Life Questionnaire-core 30. Appropriate indicators were used for descriptive statistics. Principal component analysis was used to identify symptom clusters. Associations between symptom clusters and quality of life were examined with Pearson correlation coefficients, Pearson correlation matrix and multiple linear regression. This study was reported following the STROBE checklist. RESULTS A total of 177 participants were recruited from seven hospitals in this study. We identified self-image disorder, psychological, gastrointestinal, neurological, somatic and pain symptom clusters in multiple myeloma patients with chemotherapy. Approximately 97.65% of patients suffer from multiple symptom clusters. The pain, psychological and gastrointestinal symptom clusters have negatively influence on health-related quality of life. The strongest association was found with the pain symptom cluster. CONCLUSION Most of multiple myeloma patients suffer from multiple symptom clusters. When improving the multiple myeloma patients' health-related quality of life, the clinical staff should prioritise relieving the pain symptom cluster. RELEVANCE TO CLINICAL PRACTICE When multiple myeloma patients undergoing chemotherapy suffer from multiple symptom clusters, nurses should prioritise relieving the pain symptom cluster to improve their health-related quality of life. When drawing up and providing interventions, nurses should focus on the correlation among symptoms rather than single symptom. By relieving one symptom in a given cluster, other symptoms within the same symptom cluster may also be relieved.
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Affiliation(s)
- Lihong Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Huang
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chen Qirong
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chunhong Ruan
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yaqi Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wenhong An
- School of Health and Wellness, Panzhihua University, Sichuan, China
| | - Qinqin Guo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiandang Zhou
- The Third Xiangya Hospital, Central South University, Changsha, China
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Kang Y, Kang S, Gibson D, Rodriguez AM, Prochaska J, Kaul S. Disparities in utilization of preventive health services among Asian young adults in the United States. Prev Med 2023; 175:107670. [PMID: 37586609 DOI: 10.1016/j.ypmed.2023.107670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/07/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
Despite the favorable health impacts of preventive services use, young adults remain at a higher risk of not using these services compared with older adults. This study seeks to identify barriers to receiving recommended preventive services among Asian young adults compared to other racial/ethnic young adults. Using 2016-2018 National Health Interview Survey data, this study examined barriers to recommended preventive services among non-Hispanic (NH) Asian young adults aged 18-39 years compared with other racial/ethnic groups in the United States (Total = 25,430; NH Asians = 6.3%). General prevention included fasting blood sugar, cholesterol, blood pressure, and Human Immunodeficiency Virus checkups. We documented information on vaccinations for influenza, pneumonia, tetanus, hepatitis A/B, and female-specific preventive care measures. NH Asian young adults reported blood pressure checkups less often than NH Whites (72.88% vs. 79.92%, p < 0.001). NH Asian young adults were also less likely to report HIV testing than all other racial/ethnic groups (p < 0.001). After controlling for covariates, NH Whites (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.60, 2.50), NH Blacks (OR = 1.55, 95% CI = 1.18, 2.02), and other races (OR = 2.40, 95% CI = 1.60, 3.58) were more likely to receive any preventive services than NH Asians. Among those receiving any preventive services, there were no differences between NH Asians and all other racial/ethnic groups in whether they reported receiving relatively more preventive services. Our findings demonstrate that the rates of certain recommended preventive services use were lower among NH Asian young adults. Targeted public health strategies are needed to increase the use of preventive healthcare for racial/ethnic minority young adults.
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Affiliation(s)
- Yejin Kang
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - SuJin Kang
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Building 221, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Derrick Gibson
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - Ana M Rodriguez
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Blvd Fl 3., Galveston, TX 77555, USA.
| | - John Prochaska
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - Sapna Kaul
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
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Sheridan R, McCaughan D, Hewison A, Roman E, Smith A, Patmore R, Howell D. Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers. BMJ Open 2023; 13:e070467. [PMID: 37597866 PMCID: PMC10441118 DOI: 10.1136/bmjopen-2022-070467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 08/02/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVES Patients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address. SETTING AND DESIGN Set within the UK's Haematological Malignancy Research Network (an ongoing population-based cohort that generates evidence to underpin improved clinical practice) a qualitative, exploratory study was conducted, using semistructured interviews. Reflexive thematic analysis was used to assess the interview data via an exploratory, inductive approach, underpinned by the research questions. PARTICIPANTS Thirty-five patients were included with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma; 10 of whom were interviewed alongside a relative. RESULTS Five themes were identified from the data: (1) accessing support, (2) individual coping behaviour affecting support preferences, (3) divergent and fluctuating thoughts on patient support forums, (4) the role, influence and needs of family and friends and (5) other sources of support and outstanding needs. Findings suggest that patients' individual attitudes towards support varied over time. This also influenced whether support was perceived to be available, and if it was then used. CONCLUSION This study highlighted the variation in preferences towards psychosocial support among patients with chronic haematological cancers. As patients can live for many years with significant emotional difficulties, they may benefit from frequent monitoring of their psychosocial well-being, as well as signposting to holistic support, if this is needed.
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Affiliation(s)
| | | | - Ann Hewison
- Department of Health Sciences, University of York, York, UK
| | - Eve Roman
- Department of Health Sciences, University of York, York, UK
| | | | - Russell Patmore
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, UK
| | - Debra Howell
- Department of Health Sciences, University of York, York, UK
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Bora K. Distribution of multiple myeloma in India: Heterogeneity in incidence across age, sex and geography. Cancer Epidemiol 2019; 59:215-220. [PMID: 30831554 DOI: 10.1016/j.canep.2019.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/09/2019] [Accepted: 02/14/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study aimed to investigate the distribution of multiple myeloma (MM) in India and provide a comprehensive narrative about its incidence, including differential patterns across age, sex and geography. METHODS MM cases diagnosed during 2012-14 were obtained from 27 populations based cancer registries in India by consulting the latest National Cancer Registry Programme reports. Crude (CR) and age-specific (ASR) rates of MM incidence were determined. Age-adjusted rates (AARs) were estimated by standardizing the CR values using age-specific weights recommended for LMIC countries (including India) for men and women separately, along with the corresponding 95% confidence interval (95% CI) measures. RESULTS Altogether, 1916 MM cases (male/female: 1123/793) were documented (i.e. 1.19% of all cancers, 95% CI: 1.14-1.24%). Overall CR of MM in India was 1.27 (95% CI: 1.20-1.35)/ 100,000 in men and 0.95 (95% CI: 0.89-1.02)/ 100,000 in women, while the corresponding AARs were 1.13 (95% CI: 1.07-1.20) and 0.81 (95% CI: 0.75 - 0.88) per 100,000 respectively. The ASR values increased steadily with age. Most cases belonged to the 60-69 yrs bracket. However, regional and sex-specific differences in MM profile were observed. MM incidence was highest in the Southern and Northern zones, and least in the Northeast. The Northern and Central zones had higher proportion of MM in the 50-59 yrs age group, whereas Eastern zone had higher proportion of cases aged 70 yrs and above. CONCLUSION Incidence of MM in India is presented. Marked variations in MM incidence were noted with respect to age, sex and geography.
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Affiliation(s)
- Kaustubh Bora
- Haematology Division, ICMR - Regional Medical Research Centre, N.E. Region, 786010, Dibrugarh, Assam, India.
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