Abstract
The impact of comorbid conditions represents a challenge in the management of cancer patients. We assess the impact of comorbidities on Quality of Life (QoL) in patients with haematological tumours. Real-world data were drawn from Disease Specific Programmes™ – point-in-time surveys in acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and multiple myeloma (MM) patients across the US (AML, CLL) and eight European countries (DLBCL, FL, MM) during 2015–2017. Physicians provided information regarding patient demographics, diagnosis, severity and comorbidities. Patients provided information on employment and completed the WPAI (excluding AML and CLL) and FACT-G. Linear regressions [controlling for disease type, employment, number of symptoms, age, Eastern Cooperative Oncology Group (ECOG) score] were used to predict how having comorbidities impacted FACT-G score. Bivariate analysis were conducted, all p<0.05. 1,689 patients (AML=82; CLL=317; DLBCL=39; FL=591; MM=660) were included. Mean age was 66.4 years, 44% of patients were female and 24% of patients worked full-/part-time. Mean time since diagnosis was 2.2 years (AML=0.9 CLL=2.8; DLBCL=0.9; FL=2.8; MM=1.7) and 77% of patients had a 0-1 ECOG score. 59% of patients received supportive treatments. 54% of patients had physician-reported comorbidities (mean [SD]: 2.1 [1.40]), the most common were hypertension (45%), anxiety (23%) and diabetes (22%). Patients with (n=920) vs. without comorbidities (n=769) had worse ECOG score (ECOG score 2-4: 31% vs. 13%), more symptoms (mean: 2.8 vs. 1.6). They also had clinically meaningful worse FACT-G (61.6 vs. 69.0) and worse activity impairment (44.8 vs. 37.1) scores than patients without comorbidities. Controlling for covariates, regression showed each additional comorbidity reducing FACT-G by 0.8. A large proportion of haematological tumour patients suffer from comorbidities, negatively impacting their QoL and usual activity. Awareness and effective treatment of comorbidities is an important consideration in these patients.
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