Haematologica 2003 - Supplements

those with Hb >13 g/dL. Analysis of covariance showed that this
relationship was not explained by the effect of covariates. A
higher correlation with Hb was observed for the FACT-An
Fatigue subscale than for the non-fatigue items (Spearman
r=0.277, P=.0001 vs 0.214, P=.0001, respectively). FACT-An
scores were significantly lower in older patients, particularly
older women (from 62.0 if ≤50 yrs to 51.2 if >70 yrs for women
vs 60.5 to 56.3 for men, respectively); in patients with no
response or in relapse (50.1 vs remission 58.3); and in patients
with concurrent disease (52.7 vs 58.7 without concurrent
disease). The differences between the subgroups in Hb level and
other covariates partially explained these effects. After adjusting
for Hb and other covariates (yes 56.8, no 55.9) the effect of
concomitant chemotherapy (yes 58.3, no 53.5) was no longer
significant.). In this large study population we demonstrate a
significant correlation between fatigue and Hb level in MM
patients. Hemoglobin level appears to play an important role in
determining some aspects of QOL. The treatment of anemia
should be a consideration in the global management of patients
with MM.
253
In multiple myeloma, the extent of skeletal disease and
response to therapy are more important predictors for
quality of life than hemoglobin levels
Finn Wisløff1, Nina Gulbrandsen1, Martin Hjorth2, Stig
Lenhoff3
For the Nordic Myeloma Study Group (NMSG). 1Ulleval University
Hospital, OslO, Norway; 2Lidkoping Hospital, Lidkoping and 3Lund
University Hospital, Lund, Sweden
Prospective trials have demonstrated a statistically significant
effect of erythropoietin treatment on Hb levels and quality-of-life
(QoL) in the anaemia of malignant disease. However, the effect
on QoL scores seems to be modest. In order to explore the
relationship between Hb and QoL, we pooled data from 745
patients taking part in two recent NMSG trials (4/90 and 5/94)
who had completed the QoL questionnaire EORTC QLQ-C30
prior to treatment and at regular intervals during follow-up. By
means of this questionnaire, several QoL domains, e.g. physical
functioning, global quality of life, fatigue, pain and dyspnea,
were assessed by a 0-100 scale where differences of 5-10 are
considered small, 11-20 moderate and above 20 large. QoL
scores at diagnosis were outcome variables in linear regression
analysis, with Hb, age, gender, Durie & Salmon stage, extent of
skeletal disease, beta2-microglobulin, creatinine, calcium and
albumin as predictor variables. At 12 months of follow-up, the
effect of Hb on QoL scores was adjusted for age, gender and the
degree of response to therapy (complete, partial or minor
response, no response or progressive/relapsed disease). P-values
< 0.01 were required for statistical significance.
In univariate analysis of data obtained at baseline, Hb was
significantly related only to fatigue (p