Reliability of a Novel Hematological Malignancy Specific Patient-Reported Outcome Measure: HM-PRO

The Effect of Exercise-Based Interventions on Health-Related Quality of Life of Patients with Hematological Malignancies: A Systematic Review and Meta-Analysis

Background/Objectives: Hematological cancers encompass a collection of heterogeneous conditions. The need for repeated treatments and prolonged hospitalization leads to a decrease in health-related quality of life. This systematic review and meta-analysis evaluate the effect of exercise interventions on functioning scales, global health status, and symptoms in patients with hematological cancers. Methods: PubMed, Web of Science, and Scopus databases were systematically screened, and randomized controlled trials were included. The primary outcome was health-related quality of life assessed through the European Organization for Research and Treatment of Cancer Quality of Life questionnaire. Meta-analysis was performed using a random-effects model and 95% confidence intervals. Results: A total of 14 trials involving 837 patients with mixed cancer types were included. Most studies evaluated exercise interventions during hospitalization, with aerobic and resistance training at moderate intensity being the most common modalities and adherence rates ranging from 28% to 100%. Exercise programs significantly improved physical (SMD 0.23; 95% CI: 0.06 to 0.40; p = 0.008), emotional (SMD 0.19; 95% CI: 0.03 to 0.36; p = 0.020) and cognitive functioning (SMD 0.20; 95% CI: 0.02 to 0.37; p = 0.026), and global health status (SMD 0.24; 95% CI: 0.03 to 0.46; p = 0.027). Significant reductions were observed in fatigue (SMD -0.33; 95% CI: -0.52 to -0.14; p = 0.001), pain (SMD -0.34; 95% CI: -0.53 to -0.15; p = 0.000), and insomnia (SMD -0.22; 95% CI: -0.41 to -0.03; p = 0.024). Heterogeneity was minimal across most domains, suggesting consistent findings. Conclusions: Exercise interventions are effective in enhancing functioning scales and global health status and reducing symptom burden in patients receiving intensive treatments. Future research is required to explore the long-term effects of exercise and develop tailored programs for specific hematologic malignancies and treatment settings.

Guidelines for the Use and Reporting of Patient-Reported Outcomes in Multiple Myeloma Clinical Trials

In the era of personalized medicine there is an increasing need for the assessment of patient-reported outcomes (PROs) to become a standard of patient care. Patient-reported outcome measures (PROM) are important in assessing significant and meaningful changes as a result of an intervention based on a patient's own perspective. It is well established that active multiple myeloma (MM) can be characterized by a high burden of disease and treatment-related symptoms, with considerable worsening of quality of life (QoL). In general, and over the past decade, the focus has shifted to obtaining the most durable remissions with the best QoL as primary goals for MM treatment. Patients place considerable value on their QoL and communicating about QoL data prior to treatment decisions allows them to make informed treatment choices. Consequently, optimization of QoL of patients with MM is an important therapeutic goal and the incorporation of PROs into clinical trials has the potential of improving treatment outcomes. In this regard, guidance for the use and reporting of PROMs in MM in clinical trials is warranted. Under the auspices of the European Hematology Association, evidence-based guidelines for the use and reporting of PROs in patients with MM have been developed according to the EHA's core Guidelines Development Methodology. This document provides general considerations for the choice of PROMs in MM clinical trials as well as a series of recommendations covering a selection of PROMs in MM clinical trials; the mode of administration; timing of assessments; strategies to minimize missing data; sample size calculation; reporting of results; and interpretation of results.

Important questions for the malignant hematologist to consider when designing or evaluating a study with patient-reported outcome measures (PROMs)

Patient-reported outcome measures (PROMs), which are measures of symptom burden, health-related quality of life (HRQoL), and therapy effectiveness have become increasingly important in clinical research. They are unique in that they are reported directly from the patient, without clinician interpretation, thereby avoiding clinician bias. With an increased focus on the patient at the center of health care, PROMs have been increasingly incorporated into clinical research, systematic reviews, and clinical guidelines. Despite the recognition of the importance of including PROMs into clinical haematologic cancer research, barriers have prevented their integration into cancer research. This review highlights the value of including PROMs into clinical haematologic cancer research and addresses the methodological challenges in using and evaluating PROMs. We propose important questions for the malignant haematologist to consider when designing or evaluating a study that includes PROMs.