1. A longitudinal evaluation of health-related quality of life in patients with AL amyloidosis: associations with health outcomes over time.
- Author
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Sanchorawala V, McCausland KL, White MK, Bayliss MS, Guthrie SD, Lo S, and Skinner M
- Subjects
- Aged, Amyloidosis mortality, Amyloidosis rehabilitation, Female, Humans, Kaplan-Meier Estimate, Longitudinal Studies, Male, Massachusetts epidemiology, Melphalan therapeutic use, Middle Aged, Myeloablative Agonists therapeutic use, Psychometrics, Retrospective Studies, Stem Cell Transplantation, Treatment Outcome, Amyloidosis therapy, Quality of Life
- Abstract
Light chain (AL) amyloidosis is a rare disease associated with significant, irreversible organ dysfunction and high case fatality. An observational study was conducted to assess health-related quality of life (HRQoL) in patients treated for AL amyloidosis between 1994 and 2014 with both high dose melphalan and stem cell transplantation (HDM/SCT) or non-SCT chemotherapy regimens. The SF-36v1
® Health Survey (SF-36) was administered to assess HRQoL during clinic visits. Analysis of variance was used to compare pre- and post-treatment HRQoL within each treatment group to an age- and gender-adjusted general population (GP) normative sample. Cox proportional hazard models were fit to examine associations between pre-treatment levels of HRQoL and mortality within 1 and 5 years after initiating specific treatment regimens (HDM/SCT: n = 402; non-SCT chemotherapy regimens: n = 172). Among patients who received HDM/SCT, there were significant improvements following treatment in vitality, social functioning, role-emotional and mental health. Worse pre-treatment SF-36 physical component scores were associated with a greater risk of mortality in both treatment groups and follow-up periods (P ≤ 0·005 for both). [Correction added on 20 October 2017, after first online publication: This P value has been corrected]. Using HRQoL assessments in every physician visit or treatment may provide valuable insights for treating rare conditions like AL amyloidosis., (© 2017 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd.)- Published
- 2017
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