Although clinicians take great effort to treat patients with hematologic malignancies, they often do not give enough weight to symptoms related to the disease, according to Tatyana Ionova, PhD, Multinational Center for Quality of Life Research in St. Petersburg, Russia, who presented her research on behalf of her colleagues on Saturday, December 3, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA. 

“Clinicians frequently underestimate quality of life (QoL), level of depression, and the severity of important disease- and treatment-related symptoms in patients with hematological malignancies, while overestimating other aspects of disease,” she said. 

Ionova and colleagues sought to evaluate the similarities and differences in symptom burden in 224 inpatient and outpatient adult patients with various hematologic malignancies, such as malignant lymphomas (ML), multiple myeloma (MM), and chronic myeloid leukemia (CML). Across these tumor types, the mean age ranged from 34.8 and 58 years, and most patients were women. Participants represented different disease stages—remission, stable, or progression—and different treatment phases—before, during, or after. 

The study authors generated a list of symptoms at least 10% of patients of each tumor entity experienced; specifically, 30 participants with each tumor entity identified, from the symptom list, which ones had a “significant negative burden on their everyday activities,” ranking them from “0” (no symptom) to “10” (most expressed symptom). QoL was assessed by correlating the symptoms with the highest severity and the QoL index. 

Researchers found that the symptom burden across tumor entities were similar. 

  • Participants with ML, MM, or CML reported 12 common symptoms with significant burden on QoL: weakness or fatigue, easily getting tired after physical activity, sweating at rest or during mild physical activity, decreased work energy, feeling of constant tiredness, shortness of breath, palpitation, feeling of worry or anxiety, feeling of sadness, concentration loss, feeling afraid, and nausea.
  • Common symptoms with significant burden on QoL for ML and MM were memory loss, pain, and drowsiness; for ML and CML, dizziness; and for MM and CML, heat sensations.
  • Specific symptoms with significant burden on QoL for ML were chills; for MM, bloating, numbness, dry mouth, and feeling thirsty; and for CML, sleeping problems, numbness, headache, tingling, and heart interruption.

“Better symptom control may result in improved treatment outcomes in this patient population. Adequate symptom assessment in routine clinical practice is very helpful to provide patient-centered care,” Ionova said.