CLINICS 2011;66(11):1855-1859 CLINICAL SCIENCE DOI:10.1590/S1807-59322011001100002 Autologous stem cell transplantation improves quality of life in economically challenged, Brazilian multiple myeloma patients Leina Y. Etto,I Vaˆ nia Maris Morelli,I Vanderleia C. Silva,I Vania T. M. Hungria,II Rozana M. Ciconelli,III Manuella S. S. Almeida,I Jose´ Salvador R. de Oliveira,I Jose´ Carlos Barros,II Brian G. Durie,IV Gisele W. B. ColleoniI I Universidade Federal de S a˜o Paulo (UNIFESP), Disciplina de Hematologia e Hemoterapia, Sa˜ o Paulo/SP, Brazil. II Faculdade de Cieˆ ncias M e´dicas da Santa Casa de Miserico´ rdia de S a˜o Paulo, Disciplina de Hematologia e Oncologia, Sa˜ o Paulo, SP/Brazil. III Universidade Federal de Sa˜ o Paulo (UNIFESP), Disciplina de Reumatologia, Departamento de Medicina, Sa˜ o Paulo/SP, Brazil. IV Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA, USA. OBJECTIVES: 1) To characterize the impact of multiple myeloma on the quality of life of patients treated in two public institutions in S a˜o Paulo State, Brazil, using a generic Short Form 36 Health Survey and a questionnaire specific for oncologic patients (QLQ-C30) upon diagnosis, after the clinical treatment, and at day +100 after autologous stem cell transplantation; 2) to evaluate whether autologous stem cell transplantation can improve the quality of life of our economically challenged population aside from providing a clinical benefit and disease control. METHODS: We evaluated 49 patients with multiple myeloma (a total of 70 interviews) using the two questionnaires. The scores upon diagnosis, post-treatment/pre-autologous stem cell transplantation, and at D+100 were compared using ANOVA (a comparison of the three groups), post hoc tests (two-by-two comparisons of the three groups), and paired t-tests (the same case at two different times). RESULTS : Of the included patients, 87.8% had a family budget under US $600 (economic class C, D, or E) per month. The generic Short Form 36 Health Survey questionnaire demonstrated that physical function, role-physical, and bodily pain indices were statistically different across all three groups, favoring the D+100 autologous stem cell transplantation group (ANOVA). The questionnaire specific for oncologic patients, the QLQ-C30 questionnaire, confirmed what had been demonstrated by the Short Form 36 Health Survey with respect to physical function and bodily pain, with improvements in role functioning, fatigue, and lack of appetite and constipation, favoring the D+100 autologous stem cell transplant group (ANOVA). The post hoc tests and paired t-tests confirmed a better outcome after autologous stem cell transplantation. CONCLUSION: The questionnaire specific for cancer patients seems to be more informative than the generic Short Form 36 Health Survey questionnaire and reflects the real benefit of autologous stem cell transplantation in the quality of life of multiple myeloma patients in two public Brazilian institutions that provide assistance for economically challenged patients. KEYWORDS: Myeloma; Quality of life; SF-36; QLQ-C30; Transplantation. Etto LY, Morelli VM, Silva VC, Hungria VTM, Ciconelli RM, Almeida MSS, et al. Autologous stem cell transplantation improves quality of life in economically challenged, Brazilian multiple myeloma patients. Clinics. 2011;66(11):1855-1859. Received for publication on April 27, 2011; First review completed on July 7, 2011; Accepted for publication on July 7, 2011 E-mail: gcolleoni@unifesp.br / vmorelli@unifesp.br Tel.: 55 11 5579-1550 INTRODUCTION Multiple myeloma (MM) has a significant impact on a patient’s quality of life (QoL) because the patient becomes dependent on others, even for routine activity execution and Copyright 2011 CLINICS – This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. No potential conflict of interest was reported. personal care.1 MM treatment includes therapy for the underlying disease and supportive therapy to enhance QoL. The aim of MM treatment is to control the disease, particularly its bone destruction. Healthcare professionals involved in MM treatment must minimize any post- treatment complications and ensure the best possible long- term QoL for each patient. International studies assessing the QoL of patients with MM were validated in developed countries. In Brazilian public hospitals, MM patients have important related social, economic, and emotional difficul- ties, including the following: a low family budget, unem- ployment, difficulties in receiving government financial support after diagnosis, a long distance between the home 1855