Quality of life in Brazilian MM patients Etto LY et al. CLINICS 2011;66(11):1855-1859 Table 1 - The clinical and laboratory characteristics of the 49 MM patients (upon diagnosis, post-treatment/pre-ASCT, and D+100 ASCT). Total of 70 interviews. Parameters Sex Female Male Age (years) Isotype IgG IgA IgM Light chain Non-secretor Stage IA IIA IIIA IIIB ISS 1 2 3 Upon diagnosis Post-treatment/ Pre-ASCT 15 (21.4%) 14 (20%) 55.4¡13.3 20 (28.6%) 5 (7.1%) 0 (0%) 3 (4.3%) 1 (1.4%) 2 (2.9%) 1 (1.4%) 18 (25.7%) 8 (11.5%) 10 (14.3%) 9 (12.9%) 10 (14.3%) 13 (18.6%) 14 (20%) 53.9¡9.8 21 (30%) 2 (2.9%) 1 (1.4%) 1 (1.4%) 2 (2.9%) 1 (1.4%) 1 (1.4%) 19 (27.1%) 6 (8.6%) 11 (15.7%) 8 (11.4%) 8 (11.4%) D+100 ASCT 7 (10%) 7 (10%) 54.1¡7.8 9 (12.9%) 1 (1.4%) 1 (1.4%) 2 (2.9%) 1 (1.4%) 0 (0%) 0 (0%) 13 (18.6%) 1 (1.4%) 5 (7.1%) 7 (10%) 2 (2.9%) Total 35 (50%) 35 (50%) 50 (71.5%) 8 (11.4%) 2 (2.8%) 6 (8.6%) 4 (5.7%) 3 (4.3%) 2 (2.8%) 50 (71.4%) 15 (21.5%) 26 (37.1%) 24 (34.3%) 20 (28.6%) p-value 0.965 0.856 0.717 0.583 0.593 ASCT - autologous stem cell transplantation. The ages are expressed as means ¡ standard deviations. The p-values were calculated using a chi-squared test (for the categorical variables) or ANOVA (for age). economic class C, which means that 87.8% of the included patients have a family budget of less than US $600/month (i.e., economic class C, D, or E). Therefore, it is important to apply such questionnaires in underdeveloped countries to ensure that ASCT is a good option for their incurable disease in this population. The QLQ-MY20 was not validated in Portuguese (Brazilian) when the questionnaires were applied and, therefore, was not used in our study. Although the questionnaires are designed to be self- completed, in this study the questionnaires were given during interviews performed by a principal researcher. The questionnaires were conducted in an interview because most of the patients were considered to be functionally illiterate and/or could not complete the forms alone. Others could read but were unable to understand what needed to be answered. We believe that administering the question- naire by the same person provides more uniform results. Table 2 - Analysis of variance (ANOVA) comparing the three groups according to the SF-36 questionnaire. Domains Physical function Role-physical Bodily pain General health Vitality Social function Role-emotional Mental health Physical component Mental component Post- Upon treatment/ diagnosis, Pre-ASCT, D+100 ASCT, Mean (¡SD) Mean (¡SD) Mean (¡SD) p-value 33 (¡33) 31(¡36) 36 (¡26) 60 (¡22) 58 (¡23) 45 (¡38) 49 (¡39) 64 (¡23) 33 (¡11) 47 (¡13) 44 (¡27) 47(¡28) 53 (¡23) 66 (¡14) 63 (¡17) 54 (¡31) 58 (¡24) 73 (¡19) 37 (¡8) 49 (¡8) 60 (¡25) 56 (¡29) 55 (¡28) 60 (¡14) 68 (¡24) 68 (¡25) 69 (¡33) 74 (¡21) 40 (¡7) 51 (¡11) 0.026 0.041 0.025 0.388 0.364 0.094 0.158 0.194 0.053 0.362 The p-values were calculated using an ANOVA. ASCT - autologous stem cell transplantation. One criticism of this study design is that the patient groups were not the same at the three time-points that were investigated. This could limit the power of the observation; however, the paired t-test results from both questionnaires showed improvements in the patients’ QoL. In conclusion, this study supports the use of the EORTC QLQ-C30 as part of routine clinical care in MM patients in developing countries. Our results also suggest that the questionnaire for cancer patients, QLQ-C30, seems to be more informative than the generic questionnaire, SF-36. Table 3 - Analysis of variance (ANOVA) comparing the three groups according to the QLQ-C30 questionnaire. Post- treatment/ Upon diagnosis, Pre-ASCT, D+100 ASCT, Mean (¡SD) Mean (¡SD) Mean (¡SD) p-value Scale Global health 64 (¡24) Functional scale Physical 43 (¡34) Role 39 (¡40) Emotional 64 (¡27) Cognitive 65 (¡30) Social 62 (¡31) Symptom scale Fatigue 53 (¡31) Nausea 14 (¡25) Pain 58 (¡34) Quality of life scale Dyspnea 15 (¡27) Insomnia 43 (¡31) Lack of 34 (¡47) appetite Constipation 36 (¡43) Diarrhea 2 (¡12) Financial 53 (¡41) difficulties 1858 The p-values were calculated using an ANOVA. QoL: Quality-of-life. ASCT- autologous stem cell transplant. 70 (¡22) 59 (¡24) 72 (¡34) 70 (¡28) 76 (¡23) 71 (¡35) 27(¡24) 5 (¡12) 31(¡27) 5 (¡18) 26 (¡32) 11(¡24) 9 (¡20) 0 30 (¡40) 71 (¡16) 71 (¡20) 83 (¡29) 77 (¡34) 69 (¡24) 82 (¡32) 21(¡24) 7 (¡22) 34 (¡27) 7 (¡19) 21 (¡38) 14 (¡31) 7(¡14) 9 (¡20) 31(¡38) 0.455 0.01 0.001 0.391 0.339 0.186 0.001 0.289 0.002 0.239 0.061 0.046 0.002 0.059 0.071