Symptom Clusters and Quality of Life in Ambulatory Patients With Multiple Myeloma

Abstract Purpose: The aim of this study was to investigate the symptom clusters and associated clinical factors in ambulatory multiple myeloma patients undergoing medication therapy. We also aim to determine the correlations between symptom clusters and the patients’ quality of life. Methods: A total of 174 multiple myeloma patients hospitalized in the hematology day unit were included in this study. A cross-sectional survey aimed to examine the symptoms and quality of life was conducted. The symptoms were assessed by the Chinese version of Condensed Memorial Symptom Assessment Scale. The quality of life was measured with the Functional Assessment of Cancer Therapy-General. Principal component analysis was used to identify symptom clusters. Independent-Samples t test and Chi-square test were used for comparisons between groups. Spearman’s Rank Correlation Analysis was used to identify correlations.Results: We identified three symptom clusters in multiple myeloma patients: psychological, pain-dry mouth-difficulty sleep, and fatigue symptom cluster. For each symptom cluster, the patients could be categorized in severe-symptom group or mild-symptom group based on the distress of the symptoms. The patients in each group exhibited differential demographic and clinical features. The distress of each symptom cluster was adversely correlated with patients’ quality of life.Conclusions: The ambulatory multiple myeloma patients undergoing medication therapy experience multiple symptoms, which can be categorized into three symptom clusters. The distress of each symptom cluster was associated with patients’ demographic and clinical characteristics. The presence and distress of these symptom clusters have adverse impact on patient’s quality of life.