Financial Toxicity, Time Toxicity, and Quality of Life in Multiple Myeloma.

Autor: Banerjee R; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA. Electronic address: rahul.banerjee.md@gmail.com., Cowan AJ; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Ortega M; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Missimer C; (Patient Advocate) Critical Thinking at Work, Seattle, WA., Carpenter PA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Oshima MU; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Salit RB; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Vo PT; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Lee CJ; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Mehta RS; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Kuderer NM; Advanced Cancer Research Group, Kirkland, WA., Shankaran V; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Lee SJ; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Su CT; Department of Medicine, University of Washington, Seattle, WA; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2024 Jul; Vol. 24 (7), pp. 446-454.e3. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.1016/j.clml.2024.02.013
Abstrakt: Background: Patients with multiple myeloma (MM) may be on therapy for years, which can lead to financial toxicity (FinTox) or time toxicity (TimeTox). The prevalence, predictors, and quality of life (QOL) impacts of FinTox and TimeTox during different phases of MM treatment have not been characterized.
Patients and Methods: We conducted a single-center cross-sectional survey of patients with MM who had undergone transplantation. FinTox+ was defined as a COST-FACIT score <23, TimeTox+ as MM-related interactions (including phone calls) ≥1x weekly or ≥1x monthly in-person among far-residing patients, QOL using PROMIS Global Health, and functional status using patient-reported Karnofsky performance status (KPS).
Results: Of 252 patients, 22% and 40% met FinTox+ and TimeTox+ criteria respectively. Respective FinTox+ and TimeTox+ proportions were 22%/37% for patients on maintenance, 22%/82% with active therapy, and 20%/14% with observation. FinTox+ predictors included annual income (P < .01) and out-of-pocket costs (P < .01). TimeTox+ predictors included disease status (P < .001), caregiver status (P = .01), far-residing status (P < .001), and out-of-pocket costs (P = .03). FinTox+ was associated with a clinically meaningful decrease in mental QOL, while TimeTox+ patients were more likely to have KPS ≤ 80.
Conclusions: In our large study, monetary status but not disease status predicted FinTox. Over a third of patients on maintenance reported TimeTox. FinTox+ was associated with decreased mental health, while TimeTox+ was associated with worse performance status. These two toxicities may negatively impact patient wellbeing, and studies of strategies to mitigate their impact are in development.
Competing Interests: Disclosure COI: R.B.: Consulting: BMS, Caribou Biosciences, Genentech, Janssen, Karyopharm, Pfizer, Sanofi, SparkCures; Research: Novartis, Pack Health. AJC: Consulting: BMS, Adaptive; Research: Adaptive Biotechnologies, Harpoon, Nektar, BMS, Janssen, Sanofi, AbbVie. PAC: Research: Incyte, Janssen, AbbVie, and Sanofi. CJL: Consulting: Incyte, Sanofi, Frenesius; Honoraria: Sanofi, Kite, BMS, Kadmon; Research: Incyte. RSM: Research: Incyte, Kadmon, CSL Behring. NMK: Consulting: Astra Zeneca, Janssen, Pfizer, BMS, Beyond Springs, G1 Therapeutics, Sandoz, Seattle Genetics, Fresenius. SJL: Consulting: Equillium, Kadmon, Mallinckrodt, Novartis, Incyte.; Research funding: Amgen, AstraZeneca, Incyte, Kadmon, Pfizer, Sanofi, Syndax.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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