Patient-reported symptom score predicts outcome in amyloidosis

(HealthDay)—A patient-reported symptom score can help predict clinical outcomes in patients with light-chain amyloidosis (AL), according to a study published online Feb. 9 in the American Journal of Hematology.

Rahma Warsame, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues prospectively employed a Hematology Patient Reported Symptom Screen (HPRSS), which included three questions relating to pain, fatigue, and quality of life (QOL), for 302 newly diagnosed patients with AL from 2009 to 2014.

The researchers found that the median overall survival was 53 months, and 102 deaths occurred in the first year. Baseline HPRSS differed significantly for those who lived longer than one year and early-death patients in the domains of fatigue (5 versus 7; P < 0.0001) and QOL (6 versus 5; P = 0.006). Fatigue, QOL, physician-reported performance status, autologous stem cell transplant (ASCT), and Mayo stage were prognostic for survival on univariate analysis. Mayo stage, ASCT, and baseline fatigue remained independently prognostic on multivariate analysis. QOL scores improved significantly over time among the 125 patients with HPRSS measurements at 12 months (6 to 7; P = 0.01).

"Baseline patient-reported fatigue is an independent prognostic factor for survival," the authors write. "Survival at one year was associated with significant improvement in QOL."