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Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice

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Abstract

Purpose

Chemotherapy-induced peripheral neuropathy (CIPN) may negatively influence multiple myeloma (MM) patients’ health-related quality of life (HRQOL). Dose modification is the only way to minimize CIPN. To measure CIPN in daily practice, the Indication for Common Toxicity Criteria (CTC) Grading of Peripheral Neuropathy Questionnaire (ICPNQ) was developed which can be completed within five minutes by the patient. The aims of this study were to (1) perform a psychometric evaluation of the ICPNQ and (2) examine the prevalence of CIPN and its influence on HRQOL in population-based MM patients.

Methods

One hundred fifty-six MM patients, diagnosed between 2000 and 2014, completed the ICPNQ, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy 20 (EORTC QLQ-CIPN20), and EORTC QLQ-C30 (65 % response).

Results

The psychometric analyses showed a Cronbach’s alpha of 0.84, 0.74, and 0.61 for, respectively, the sensory, motoric, and autonomic subscales of the ICPNQ. Test-retest reliability and construct validity were good for all subscales. Overall, 65 % of patients reported grade 2–3 neuropathy according to the ICPNQ. Patients with the highest CTC grades (grade 2 with neuropathic pain and grade 3 (38 %)) according to the ICPNQ reported significantly worse scores on all EORTC QLQ-CIPN20 subscales compared to patients with lower CTC grades (p ≤ 0.002). In addition, they reported statistically significant and clinically relevant worse HRQOL scores on almost all EORTC QLQ-C30 subscales.

Conclusions

CIPN is a common side effect in MM patients, which has a negative impact on HRQOL. The ICPNQ is a valid instrument to distinguish the highest CIPN CTC grades from the lower CTC grades necessary to decide on dose modifications of chemotherapy in daily clinical practice.

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References

  1. Jordan K, Proskorovsky I, Lewis P, Ishak J, Payne K, Lordan N, et al. (2014) Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: results of a European, multicenter cohort study. Support Care Cancer 22:417–426

    Article  PubMed  PubMed Central  Google Scholar 

  2. Mols F, Oerlemans S, Vos AH, Koster A, Verelst S, Sonneveld P, et al. (2012) Health-related quality of life and disease-specific complaints among multiple myeloma patients up to 10 yr after diagnosis: results from a population-based study using the PROFILES registry. Eur J Haematol 89:311–319

    Article  PubMed  Google Scholar 

  3. Delforge M, Blade J, Dimopoulos MA, Facon T, Kropff M, Ludwig H, et al. (2010) Treatment-related peripheral neuropathy in multiple myeloma: the challenge continues. Lancet Oncol 11:1086–1095

    Article  CAS  PubMed  Google Scholar 

  4. Jongen JL, Broijl A, Sonneveld P (2015) Chemotherapy-induced peripheral neuropathies in hematological malignancies. J Neuro-Oncol 121:229–237

    Article  CAS  Google Scholar 

  5. Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G, et al. (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32:1941–1967

    Article  CAS  PubMed  Google Scholar 

  6. Cavaletti G, Frigeni B, Lanzani F, Mattavelli L, Susani E, Alberti P, et al. (2010) Chemotherapy-induced peripheral neurotoxicity assessment: a critical revision of the currently available tools. Eur J Cancer 46:479–494

    Article  CAS  PubMed  Google Scholar 

  7. Cavaletti G, Cornblath DR, Merkies IS, Postma TJ, Rossi E, Frigeni B, et al. (2013) The chemotherapy-induced peripheral neuropathy outcome measures standardization study: from consensus to the first validity and reliability findings. Ann Oncol 24:454–462

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Zweegman S, Lokhorst HM, Levin MD, Waal de E, Bos GMJ, Kersten MJ, et al. (2012) Guidelines for the treatment of multiple myeloma 2012. Ned Tijdschr Hematol 8:300–320

    Google Scholar 

  9. Di Maio M, Gallo C, Leighl NB, Piccirillo MC, Daniele G, Nuzzo F, et al. (2015) Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials. J Clin Oncol 33:910–915

    Article  PubMed  Google Scholar 

  10. Postma TJ, Heimans JJ, Muller MJ, Ossenkoppele GJ, Vermorken JB, Aaronson NK (1998) Pitfalls in grading severity of chemotherapy-induced peripheral neuropathy. Ann Oncol 9:739–744

    Article  CAS  PubMed  Google Scholar 

  11. Basch E, Iasonos A, McDonough T, Barz A, Culkin A, Kris MG, et al. (2006) Patient versus clinician symptom reporting using the National Cancer Institute common terminology criteria for adverse events: results of a questionnaire-based study. Lancet Oncol 7:903–909

    Article  PubMed  Google Scholar 

  12. Mols F, Beijers T, Vreugdenhil G, van de Poll-Franse L (2014) Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Support Care Cancer 22:2261–2269

    Article  PubMed  Google Scholar 

  13. van de Poll-Franse LV, Horevoorts N, van Eenbergen M, Denollet J, Roukema JA, Aaronson NK, et al. (2011) The Patient Reported Outcomes Following Initial Treatment and Long Term Evaluation Of Survivorship registry: scope, rationale and design of an infrastructure for the study of physical and psychosocial outcomes in cancer survivorship cohorts. Eur J Cancer 47:2188–2194

    Article  PubMed  Google Scholar 

  14. PHAROS. Population-based Haematological Registry for Observational Studies (PHAROS), http://www.pharosregistry.nl/. Accessed 1 June 2015

  15. Postma TJ, Aaronson NK, Heimans JJ, Muller MJ, Hildebrand JG, Delattre JY, et al. (2005) The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer 41:1135–1139

    Article  CAS  PubMed  Google Scholar 

  16. Calhoun EA, Welshman EE, Chang CH, Lurain JR, Fishman DA, Hunt TL, et al. (2003) Psychometric evaluation of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire for patients receiving systemic chemotherapy. Int J Gynecol Cancer 13:741–748

    Article  CAS  PubMed  Google Scholar 

  17. Cavaletti G, Bogliun G, Marzorati L, Zincone A, Piatti M, Colombo N, et al. (2003) Grading of chemotherapy-induced peripheral neurotoxicity using the total neuropathy scale. Neurology 61:1297–1300

    Article  CAS  PubMed  Google Scholar 

  18. Hausheer FH, Schilsky RL, Bain S, Berghorn EJ, Lieberman F (2006) Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. Semin Oncol 33:15–49

    Article  CAS  PubMed  Google Scholar 

  19. Wisloff F, Eika S, Hippe E, Hjorth M, Holmberg E, Kaasa S, et al. (1996) Measurement of health-related quality of life in multiple myeloma. Nordic Myeloma Study Group. Br J Haematol 92:604–613

    Article  CAS  PubMed  Google Scholar 

  20. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  CAS  PubMed  Google Scholar 

  21. Michielsen HJ, De Vries J, Van Heck GL (2003) Psychometric qualities of a brief self-rated fatigue measure: the fatigue assessment scale. J Psychosom Res 54:345–352

    Article  PubMed  Google Scholar 

  22. Nunnally JC (1978) Psychometric theory. McGraw-Hill, New York

    Google Scholar 

  23. Richardson PG, Delforge M, Beksac M, Wen P, Jongen JL, Sezer O, et al. (2012) Management of treatment-emergent peripheral neuropathy in multiple myeloma. Leukemia 26:595–608

    Article  CAS  PubMed  Google Scholar 

  24. Babyak MA (2004) What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med 66:411–421

    PubMed  Google Scholar 

  25. Burnand B, Kernan WN, Feinstein AR (1990) Indexes and boundaries for "quantitative significance" in statistical decisions. J Clin Epidemiol 43:1273–1284

    Article  CAS  PubMed  Google Scholar 

  26. Cocks K, King MT, Velikova G, Martyn St-James M, Fayers PM, Brown JM (2011) Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. J Clin Oncol 29:89–96

    Article  PubMed  Google Scholar 

  27. Lee SJ, Richardson PG, Sonneveld P, Schuster MW, Irwin D, San Miguel JF, et al. (2008) Bortezomib is associated with better health-related quality of life than high-dose dexamethasone in patients with relapsed multiple myeloma: results from the APEX study. Br J Haematol 143:511–519

    CAS  PubMed  Google Scholar 

  28. Dubois D, Dhawan R, van de Velde H, Esseltine D, Gupta S, Viala M, et al. (2006) Descriptive and prognostic value of patient-reported outcomes: the bortezomib experience in relapsed and refractory multiple myeloma. J Clin Oncol 24:976–982

    Article  CAS  PubMed  Google Scholar 

  29. Boland E, Eiser C, Ezaydi Y, Greenfield DM, Ahmedzai SH, Snowden JA (2013) Living with advanced but stable multiple myeloma: a study of the symptom burden and cumulative effects of disease and intensive (hematopoietic stem cell transplant-based) treatment on health-related quality of life. J Pain Symptom Manag 46:671–680

    Article  Google Scholar 

  30. Lavoie Smith EM, Barton DL, Qin R, Steen PD, Aaronson NK, Loprinzi CL (2013) Assessing patient-reported peripheral neuropathy: the reliability and validity of the European Organization for Research and Treatment of Cancer QLQ-CIPN20 Questionnaire. Qual Life Res 22:2787–2799

    Article  PubMed  PubMed Central  Google Scholar 

  31. van der Poel MW, Oerlemans S, Schouten HC, van de Poll-Franse LV (2015) Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 94:651–661

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank all the patients and their doctors for their participation in the study. We want to thank the following hospitals for their cooperation: Amphia hospital, Breda; Bernhoven hospital, Veghel and Oss; Catharina hospital, Eindhoven; Elkerliek hospital, Helmond; Jeroen Bosch hospital, ‘s Hertogenbosch; Máxima Medical Centre, Eindhoven and Veldhoven; Sint Anna hospital, Geldrop; St. Elisabeth hospital, Tilburg; Twee Steden hospital, Tilburg and Waalwijk; and VieCuri hospital, Venlo and Venray.

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Authors and Affiliations

  1. Department of Internal Medicine, Máxima Medical Center, De Run 4600, Veldhoven, PO Box 7777, 5504 DB, the Netherlands

    A. J. M. Beijers & G. Vreugdenhil

  2. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands

    A. J. M. Beijers, S. Oerlemans, L. V. van de Poll-Franse & F. Mols

  3. Department of Medical Oncology, Maastricht University Medical Center, Maastricht, the Netherlands

    G. Vreugdenhil

  4. CoRPS—Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands

    S. Oerlemans, L. V. van de Poll-Franse & F. Mols

  5. Department of Neurology, Spaarne Hospital, Hoofddorp, the Netherlands

    M. Eurelings

  6. Department of Hematology, UMC Utrecht Cancer Center, Utrecht, the Netherlands

    M. C. Minnema

  7. Department of Hematology, VU University Medical Center, Amsterdam, the Netherlands

    C. M. Eeltink

Authors
  1. A. J. M. Beijers
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  2. G. Vreugdenhil
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  3. S. Oerlemans
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  4. M. Eurelings
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  7. L. V. van de Poll-Franse
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  8. F. Mols
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Corresponding author

Correspondence to A. J. M. Beijers.

Ethics declarations

This study was approved by the certified Medical Ethics Committee of the Máxima Medical Center. All patients gave written informed consent.

Funding

The present research was supported by Janssen-Cilag pharmaceutical companies of Johnson-Johnson for the validation of the ICPNQ and granted to the Netherlands Comprehensive Cancer Organization (IKNL), Netherlands Cancer Registry, Eindhoven. Moreover, this study was financially supported by the Jonker-Driessen Foundation and ZonMW: the Netherlands organization for health research and development, and through PHAROS: Population-Based Hematological Registry for Observational Studies (#80-82500-98-01007).

Conflict of interest

The present research was supported by Janssen-Cilag pharmaceutical companies of Johnson-Johnson for the validation of the ICPNQ and granted to the Netherlands Comprehensive Cancer Organization (IKNL), Netherlands Cancer Registry, Eindhoven.

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Beijers, A.J.M., Vreugdenhil, G., Oerlemans, S. et al. Chemotherapy-induced neuropathy in multiple myeloma: influence on quality of life and development of a questionnaire to compose common toxicity criteria grading for use in daily clinical practice. Support Care Cancer 24, 2411–2420 (2016). https://doi.org/10.1007/s00520-015-3032-y

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