What Are the Predictors of Health-related Quality of Life and Cost in Multiple Myeloma? A Meta-analysis

Research output: Contribution to journalPoster abstractpeer-review


Background: Multiple myeloma is associated with a higher
burden of disease than other haematological cancers.
To understand the determinants of low health-related quality
of life (HrQoL) or high cost/health care use could help
identify those patients at risk of developing a worse outcome
and target services towards them.
Aim: To systematically review, assess and analyse the
strength of association between different disease factors
and the outcomes HrQoL, cost and health care utilisation
in multiple myeloma.
Method: We searched Medline, Embase, PsycINFO,
Cinahl, Assia, the Cochrane library and NHS EED databases,
journals and citations using keywords/subject
headings for myeloma and QoL or cost/health care use.
Inclusion criteria: Studies reporting associations in samples
≥50% myeloma. Fisher’s z method for correlations and
random effects meta-analysis.
Results: Of 20,883 references, 43 studies with 4,960 participants
were included. None reported associations for
both outcomes. The largest effect sizes were found for
nutritional risk and fatigue (r=-0.51 and -0.54) associated
with worse HrQoL. Medium associations were reported
for other symptoms and biochemical parameters like
M-protein level, creatinine etc. High haemoglobin was a
moderate protective factor for HrQoL (r=0.39). Demographic,
disease- and treatment-related factors showed weak
associations only, except for response (r=0.29, 95%CI
0.24-0.34). Treatment-related factors were the main drivers
of cost (days in intensive care, laboratory procedures
(r=0.52)). Moderate associations were found for disease
stage, duration of maintenance treatment. A higher platelet
count was weakly associated with lower costs (r=-0.22,
95% CI:-0.38 to -0.05).
Conclusion: A model of predictors for HrQoL in myeloma
was developed. Early detection of those at risk for developing
worse HrQoL or higher cost/hospitalisation should
consider symptoms as well as biochemical factors and cannot
focus on response or treatment alone.
Original languageEnglish
Pages (from-to)631-631
Number of pages1
JournalPalliative Medicine
Issue number6
Publication statusPublished - 2014


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