**16. Conclusion**

C30 and the myeloma-specific module (QLQ-MY24) at baseline and at predetermined intervals during treatment. The QLQ-C30 subscales physical function and constipation showed an improvement during induction in favour of the MP arm. During thalidomide maintenance, the scores for the QLQ-MY24 paraesthesia became significantly higher in the MPT arm. The QLQ-C30 subscales pain, insomnia and appetite loss and the QLQ-MY24 item sick scored marginally better during thalidomide maintenance. The overall QoLscale QLQ-C30-HRQoL showed a significant time trend towards more favorable mean values during protocol treatment without differences between MP and MPT. For the QLQ-C30 subscales emotional function and future perspectives, difference in favour of the MPT arm from the start of treatment was observed with no significant 'time × arm' interac‐ tion, indicating a persistent better patient perspective with MPT treatment. The study concluded that the higher frequency of toxicity associated with MPT does not translate into

284 Multiple Myeloma - A Quick Reflection on the Fast Progress

a negative effect on HRQoL and that MPT holds a better patient perspective [33].

estimated median survival of 17, 29 and 49 months, respectively [34].

40.8% were worried about their health in the future [35].

**MM**

Quality-of-life assessment may be an independent and valuable addition to the known prognostic factors in multiple myeloma. In a randomized trial (NMSG 4/90), patients treated with melphalan/prednisone were compared to a melphalan/prednisone + interfer‐ on alpha-2b treated patient group in 486 newly diagnosed multiple myeloma. Univariate analysis showed a highly significant association with survival from the start of therapy for physical functioning as well as role and cognitive functioning, global quality of life, fatigue and pain. In multivariate analysis, physical functioning and W.H.O. performance status were independent prognostic factors when analysed in a Cox regression model with the somatic variables beta-2 microglobulin, skeletal disease and age. The best prediction for survival from the start of therapy was obtained by combining the beta-2 microglobulin and physical functioning scores in a variable consisting of three risk factor levels with an

**15. Assessment of the correlation of psychological well-being and QoL in**

A cross-sectional survey was conducted aiming to identify the nature and range of needs, as well as levels of quality of life (QoL), of both patients living with myeloma and their partners. Patients and their partners were recruited from 4 hospitals in the United Kingdom at a mean post-diagnosis time of 5 years. A total of 132 patients and 93 of their partners participated. One-quarter of the patients and one-third of the partners reported unmet supportive care needs. About 27.4% of patients reported signs of anxiety and 25.2% reported signs of depression. Almost half the partners (48.8%) reported signs of anxiety and 13.6% exhibited signs of depression. Anxious/depressed patients had more than double the unmet needs than non-anxious/depressed patients (P<0.05). QoL was moderate, with key areas of impairment being physical, emotional, social and cognitive functioning. Patients complained of several symptoms, including tiredness (40.7%), pain (35.9%), insomnia (32.3%), peripheral neuropathies (28.3%) and memory problems (22.3%). About

Investigation of QoL has become increasingly important in economically developed countries. HRQoL assessment is becoming a current and integral part of clinical studies with new drugs. Measuring of QoL is becoming more and more important for decision making in the field of health policy.

MM is a currently incurable disease, but survival can be significantly prolonged by the administration of new therapeutic modalities. The mean age at the time of diagnosis is over 60, so it is especially important to choose the least harmful treatment for the patient so the best quality of life can be achieved. Results of QoL examinations can help us find the most appro‐ priate treatment for our patients.
