Health-related quality of life in transplant ineligible newly diagnosed multiple myeloma patients treated with either thalidomide or lenalidomide-based regimen until progression: a prospective, open-label, multicenter, randomized, phase 3 study

Data on the impact of long term treatment with immunomodulatory drugs (IMiD) on health-related quality of life (HRQoL) is limited. The HOVON-87/NMSG18 study was a randomized, phase 3 study in newly diagnosed transplant ineligible patients with multiple myeloma, comparing melphalan-prednisolone in combination with thalidomide or lenalidomide, followed by maintenance therapy until progression (MPT-T or MPR-R). The EORTC QLQ-C30 and MY20 questionnaires were completed at baseline, after three and nine induction cycles and six and 12 months of maintenance therapy. Linear mixed models and minimal important differences were used for evaluation. 596 patients participated in HRQoL reporting. Patients reported clinically relevant improvement in global quality of life (QoL), future perspective and role and emotional functioning, and less fatigue and pain in both arms. The latter being of large effect size

The combination of four different clinical decision rules and an ageadjustedd-dimer cut-off increases the number of patients in whomacute pulmonary embolism can safely be excluded

Four clinical decision rules (CDRs) (Wells score, Revised Geneva Score(RGS), simplified Wells score and simplified RGS) safely exclude pulmonaryembolism (PE), when combined with a normal D-dimer test. Recently,an age-adjusted cut-off of the D-dimer (patient's age x 10 μg/l)safely increased the number of patients above 50 years in whom PEcould safely be excluded. We validated the age-adjusted D-dimer testand assessed its performance in combination with the four CDRs in patientswith suspected PE. A total of 414 consecutive patients with suspectedPE who were older than 50 years were included. The proportionof patients in whom PE could be excluded with an 'unlikely' clinicalprobability combined with a normal age-adjusted D-dimer test was calculatedand compared with the proportion using the conventionalD-dimer cut-off. We assessed venous thromboembo