分析骨骼疼痛、一般症状和患者报告的结果测量及其在检测症状进展中的价值——多发性骨髓瘤患者的跨学科前瞻性研究

IF 3.4 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-05-08 DOI:10.1016/j.jbo.2025.100685

Carlotta Pietsch , Monika Engelhardt , Gabriele Ihorst , Laura Wystrach , Johannes Jung , Hagen Schmal , Andreas Frodl , Ralph Wäsch , Evangelos Terpos , Georg W. Herget

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引用次数: 0

摘要

多发性骨髓瘤（MM）和进行性疾病（PD）的延迟诊断既会增加骨骼并发症的风险，也会影响患者的生活质量（QoL）。在这项前瞻性研究中，我们分析了MM患者的骨骼疼痛、一般症状和患者报告的结果测量（PROMs）及其在检测症状进展中的价值。我们评估了502例患者，其中47例为初诊MM， 455例为随访患者。在ID时，74%的患者报告骨痛，主要在脊柱。一般症状，特别是疲劳，出现在89%的患者。88/455（19%）的随访患者出现PD。其中，65%报告骨骼疼痛，81%表现出一般症状，疲劳是最常见的。59/88（67%）怀疑并确认PD为临床症状的原因，29/88（33%）未怀疑PD。骨痛和一般症状的发生和特征在PD患者和非PD患者之间存在显著差异，生活质量和健康状况也存在显著差异。Logistic回归分析显示，夜间骨痛、不同部位疼痛、不同部位发生的已知特征疼痛、胸部、骨盆和大腿疼痛以及疲劳和体重减轻与PD风险增加相关。总之，骨痛和一般症状有助于鉴别MM和PD。PROMs可以通过基于症状的患者评估来帮助诊断PD。血清学和，特别是骨骼疾病的情况下，需要额外的放射学诊断来确认疑似和发现意外的PD。

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Analysis of skeletal pain, general symptoms and patient-reported outcome measures and their value in detecting symptomatic progression – An interdisciplinary prospective study in patients with multiple myeloma

Delayed diagnosis of multiple myeloma (MM) and progressive disease (PD) can both increase the risk of skeletal complications and do affects patients’ quality of life (QoL). In this prospective study we analyzed skeletal pain, general symptoms and patient-reported outcome measures (PROMs) in patients with MM and their value in detecting symptomatic progression.

We evaluated 502 patients, 47 with initial diagnosis (ID) of MM and 455 follow-up patients. At ID, 74% reported bone pain, mostly in the spine. General symptoms, particularly fatigue, were present in 89% of the patients. 88/455 (19%) of the follow-up patients experienced PD. Of these, 65% reported skeletal pain and 81% exhibited general symptoms, with fatigue being the most common. PD was suspected and confirmed as the cause of clinical symptoms in 59/88 (67%) and not suspected in 29/88 (33%). Occurrence and character of bone pain and general symptoms differed significantly between patients with and without PD, as did QoL and health-related status. Logistic regression analysis demonstrated that bone pain at night, pain in various locations, pain of known character with occurrence in different location, pain in the chest, pelvis, and thigh as well as fatigue and weight loss were associated with an increased risk of PD.

In conclusion, bone pain and general symptoms are helpful in identifying both MM and PD. PROMs can aid in the diagnosis of PD through symptom-based patient assessment. Serologic and, especially in the case of skeletal complaints, additional radiologic diagnostics are required to confirm suspected and to detect unexpected PD.

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.