CLINICS 2011;66(11):1855-1859 Quality of life in Brazilian MM patients Etto LY et al. Figure 1 - A flow diagram of the study design. ASCT - autologous stem cell transplantation. the same case at two different times) demonstrated improvements in fatigue (p = 0.036) and global health (p = 0.045) after clinical treatment compared to the time of diagnosis (as determined by the QLQ-C30). This finding confirms the post hoc results. Paired t-tests demonstrated improvements in physical function (p = 0.022) and role- emotional (p = 0.043) when the patients at the end of their clinical treatments were compared to the patients at D+100 ASCT using the SF-36 questionnaire. The QLQ-C30 detected significant improvements in the global health (p = 0.034) and social characteristics (p = 0.044) when the same patients in the two aforementioned situations were compared. DISCUSSION In this study, we characterized the impact of MM on the QoL of patients treated in two public institutions in Sa˜o Paulo State, Brazil, using a generic (SF-36) questionnaire and a questionnaire specific for oncologic patients (QLQ-C30) upon diagnosis, after clinical treatment and at day +100 after ASCT. The SF-36 is an internationally validated instrument that can be self-administered or given over the phone. This questionnaire has been adapted and validated in Portuguese since 1999.2 We found only one previous report that described the use of the SF-36 questionnaire in MM patients to compare QoL pre- and post-kyphoplasty.6 Recently, the EORTC validated a disease-specific question- naire module (QLQ-MY20) for patients with MM. The study was performed through the EORTC Quality of Life Group using clinical trials in seven countries. The social support scale was removed in the final analysis because it did not discriminate between the groups in this population.7 The differences observed when comparing the MM patients upon diagnosis and at D+100 ASCT were already present in one recent QoL study from the University of Arkansas for Medical Sciences, Little Rock, that used other indices.8 However, in Brazilian public hospitals, the economic situation of MM patients is completely different from that of developed countries, where all of the questionnaires were designed. The majority of patients in this study are in 1857