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Published in: Orphanet Journal of Rare Diseases 1/2022

Open Access 01-12-2022 | Mastocytosis | Research

Health-related quality of life and health literacy in patients with systemic mastocytosis and mast cell activation syndrome

Authors: Tobias Jürgen Schmidt, Julia Sellin, Gerhard J. Molderings, Rupert Conrad, Martin Mücke

Published in: Orphanet Journal of Rare Diseases | Issue 1/2022

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Abstract

Background

Systemic mastocytosis is a rare genetic disease characterized by aberrant proliferation and/or activation of mast cells, resulting in multi-organ, allergy-like symptoms. Mast cell activation syndrome (MCAS) is a clinically similar, but more prevalent disease with unclear etiology. In this study, the health-related quality of life (HRQOL) and health literacy of people suffering from SM and MCAS were assessed.

Results

Two validated questionnaires (QLQ-C30/QLQ-INFO25) from the European Organisation for Research and Treatment of Cancer (EORTC) were used to analyze HRQOL and level of information of SM and MCAS patients. In addition, a control group without any health issues was included. Data were analyzed by ANOVA and linear regression to detect significant differences. Questionnaire data from 66 patients with MCAS (83% female, mean 44 years), 32 patients with SM (78% female, mean 53 years) and 52 healthy participants (67% female, mean 48 years) resident in Germany were analyzed. HRQOL as measured by the Global health status was significantly worse in patients suffering from MCAS or SM compared to control group. Individuals with MCAS showed a slightly, but insignificantly lower score on Global health status, and a significantly lower score with respect to role function and fatigue. Patients with the rare disease SM felt significantly better informed on their disease compared to MCAS patients. Linear regression performed separately for both groups showed a direct influence of the level of information on patients' HRQOL.

Conclusion

Overall, our study showed a significant negative impact on the HRQOL of both diseases, but only a small difference in quality of life and severity of symptoms between patients with MCAS and the supposedly more severe form, the rare disease SM. Our results demonstrate that the level of information patients receive impacts HRQOL, and that this is not only an issue in rare diseases, but also diseases with unclear etiology and pathology. Our data shows that even slight improvements in the patient's level of information can have a positive effect on their quality of life, further highlighting the importance of gaining more knowledge on rare and incompletely understood diseases and communicating these insights to patients.
Literature
1.
go back to reference Wirz S, Molderings GJ. A practical guide for treatment of pain in patients with systemic mast cell activation disease. Pain Phys. 2017;20(6):849–61. Wirz S, Molderings GJ. A practical guide for treatment of pain in patients with systemic mast cell activation disease. Pain Phys. 2017;20(6):849–61.
2.
go back to reference Afrin LB, Ackerley MB, Bluestein LS, Brewer JH, Brook JB, Buchanan AD, et al. Diagnosis of mast cell activation syndrome: a global “consensus-2.” Diagnosis (Berl). 2021;8(2):137–52.CrossRefPubMed Afrin LB, Ackerley MB, Bluestein LS, Brewer JH, Brook JB, Buchanan AD, et al. Diagnosis of mast cell activation syndrome: a global “consensus-2.” Diagnosis (Berl). 2021;8(2):137–52.CrossRefPubMed
3.
go back to reference Molderings GJ. Transgenerational transmission of systemic mast cell activation disease—genetic and epigenetic features. Transl Res. 2016;174:86–97.CrossRefPubMed Molderings GJ. Transgenerational transmission of systemic mast cell activation disease—genetic and epigenetic features. Transl Res. 2016;174:86–97.CrossRefPubMed
4.
go back to reference Homann J, Kolck UW, Ehnes A, Frieling T, Raithel M, Molderings GJ. Die systemische Mastozytose – Standortbestimmung einer internistischen Erkrankung. Med Klin (Munich). 2010;105(8):544–53.CrossRefPubMed Homann J, Kolck UW, Ehnes A, Frieling T, Raithel M, Molderings GJ. Die systemische Mastozytose – Standortbestimmung einer internistischen Erkrankung. Med Klin (Munich). 2010;105(8):544–53.CrossRefPubMed
6.
go back to reference Akin C, Boyce JA. Systemische Mastozytose. In: Harrisons Innere Medizin 3 3. 20th ed. Berlin: Thieme; 2020. p. 3107–9. Akin C, Boyce JA. Systemische Mastozytose. In: Harrisons Innere Medizin 3 3. 20th ed. Berlin: Thieme; 2020. p. 3107–9.
7.
go back to reference Valent P, Horny H-P, Escribano L, Longley BJ, Li CY, Schwartz LB, et al. Diagnostic criteria and classification of mastocytosis: a consensus proposal. Leuk Res. 2001;25(7):603–25.CrossRefPubMed Valent P, Horny H-P, Escribano L, Longley BJ, Li CY, Schwartz LB, et al. Diagnostic criteria and classification of mastocytosis: a consensus proposal. Leuk Res. 2001;25(7):603–25.CrossRefPubMed
8.
go back to reference Molderings GJ, Brüss M, Raithel M, Wilken V, Hartmann K, Brockow K, et al. Systemische Mastozytose als Grund für chronische gastrointestinale Beschwerden: Praxisorientierte Hinweise zu Diagnostik und Therapie. Dtsch Arztebl Int. 2005;102(24):A-1744. Molderings GJ, Brüss M, Raithel M, Wilken V, Hartmann K, Brockow K, et al. Systemische Mastozytose als Grund für chronische gastrointestinale Beschwerden: Praxisorientierte Hinweise zu Diagnostik und Therapie. Dtsch Arztebl Int. 2005;102(24):A-1744.
9.
go back to reference Weiler CR, Alhurani RE, Butterfield JH, Divekar R. Systemic mastocytosis (SM) and mast cell activation syndrome (MCAS); how do they differ? J Allergy Clin Immunol. 2018;141(2):AB275.CrossRef Weiler CR, Alhurani RE, Butterfield JH, Divekar R. Systemic mastocytosis (SM) and mast cell activation syndrome (MCAS); how do they differ? J Allergy Clin Immunol. 2018;141(2):AB275.CrossRef
10.
go back to reference Molderings G, Homann J, Brettner S, Raithel M, Frieling T. Systemische Mastzellaktivierungserkrankung: Ein praxisorientierter Leitfaden zu Diagnostik und Therapie. Dtsch med Wochenschr. 2014;139(30):1523–38.CrossRefPubMed Molderings G, Homann J, Brettner S, Raithel M, Frieling T. Systemische Mastzellaktivierungserkrankung: Ein praxisorientierter Leitfaden zu Diagnostik und Therapie. Dtsch med Wochenschr. 2014;139(30):1523–38.CrossRefPubMed
11.
go back to reference Valent P, Akin C, Nedoszytko B, Bonadonna P, Hartmann K, Niedoszytko M, et al. Diagnosis, classification and management of mast cell activation syndromes (MCAS) in the era of personalized medicine. IJMS. 2020;21(23):9030.CrossRefPubMedPubMedCentral Valent P, Akin C, Nedoszytko B, Bonadonna P, Hartmann K, Niedoszytko M, et al. Diagnosis, classification and management of mast cell activation syndromes (MCAS) in the era of personalized medicine. IJMS. 2020;21(23):9030.CrossRefPubMedPubMedCentral
12.
go back to reference Valent P, Akin C, Arock M, Brockow K, Butterfield JH, Carter MC, et al. Definitions, criteria and global classification of mast cell disorders with special reference to mast cell activation syndromes: a consensus proposal. Int Arch Allergy Immunol. 2012;157(3):215–25.CrossRefPubMed Valent P, Akin C, Arock M, Brockow K, Butterfield JH, Carter MC, et al. Definitions, criteria and global classification of mast cell disorders with special reference to mast cell activation syndromes: a consensus proposal. Int Arch Allergy Immunol. 2012;157(3):215–25.CrossRefPubMed
13.
go back to reference Wirz S, Molderings GJ. A practical guide for treatment of pain in patients with systemic mast cell activation disease. Pain Phys. 2017;20(6):E849–61. Wirz S, Molderings GJ. A practical guide for treatment of pain in patients with systemic mast cell activation disease. Pain Phys. 2017;20(6):E849–61.
14.
go back to reference Vermeiren MR, Kranenburg LW, van Daele PLA, Gerth van Wijk R, Hermans MAW. Psychological functioning and quality of life in patients with mastocytosis. Ann Allergy Asthma Immunol. 2020;124(4):373-378.e2.CrossRefPubMed Vermeiren MR, Kranenburg LW, van Daele PLA, Gerth van Wijk R, Hermans MAW. Psychological functioning and quality of life in patients with mastocytosis. Ann Allergy Asthma Immunol. 2020;124(4):373-378.e2.CrossRefPubMed
15.
go back to reference Pulfer S, Ziehfreund S, Gebhard J, Hindelang B, Biedermann T, Brockow K, et al. Health-related quality of life and influencing factors in adults with nonadvanced mastocytosis—a cross-sectional study and qualitative approach. J Allergy Clin Immunol Pract. 2021;9:3166-3175.e2.CrossRefPubMed Pulfer S, Ziehfreund S, Gebhard J, Hindelang B, Biedermann T, Brockow K, et al. Health-related quality of life and influencing factors in adults with nonadvanced mastocytosis—a cross-sectional study and qualitative approach. J Allergy Clin Immunol Pract. 2021;9:3166-3175.e2.CrossRefPubMed
16.
go back to reference van Anrooij B, Kluin-Nelemans JC, Safy M, Flokstra-de Blok BMJ, Oude Elberink JNG. Patient-reported disease-specific quality-of-life and symptom severity in systemic mastocytosis. Allergy. 2016;71(11):1585–93.CrossRefPubMed van Anrooij B, Kluin-Nelemans JC, Safy M, Flokstra-de Blok BMJ, Oude Elberink JNG. Patient-reported disease-specific quality-of-life and symptom severity in systemic mastocytosis. Allergy. 2016;71(11):1585–93.CrossRefPubMed
17.
go back to reference Siebenhaar F, von Tschirnhaus E, Hartmann K, Rabenhorst A, Staubach P, Peveling-Oberhag A, et al. Development and validation of the mastocytosis quality of life questionnaire: MC-QoL. Allergy. 2016;71(6):869–77.CrossRefPubMed Siebenhaar F, von Tschirnhaus E, Hartmann K, Rabenhorst A, Staubach P, Peveling-Oberhag A, et al. Development and validation of the mastocytosis quality of life questionnaire: MC-QoL. Allergy. 2016;71(6):869–77.CrossRefPubMed
18.
go back to reference Jhamb M, Liang K, Yabes J, Steel JL, Dew MA, Shah N, et al. Prevalence and correlates of fatigue in chronic kidney disease and end-stage renal disease: are sleep disorders a key to understanding fatigue? Am J Nephrol. 2013;38(6):489–95.CrossRefPubMed Jhamb M, Liang K, Yabes J, Steel JL, Dew MA, Shah N, et al. Prevalence and correlates of fatigue in chronic kidney disease and end-stage renal disease: are sleep disorders a key to understanding fatigue? Am J Nephrol. 2013;38(6):489–95.CrossRefPubMed
19.
go back to reference Hansen L, Sasaki A, Zucker B. End-stage liver disease: challenges and practice implications. Nurs Clin N Am. 2010;45(3):411–26.CrossRef Hansen L, Sasaki A, Zucker B. End-stage liver disease: challenges and practice implications. Nurs Clin N Am. 2010;45(3):411–26.CrossRef
20.
go back to reference Janssen DJA, Spruit MA, Uszko-Lencer NH, Schols JMGA, Wouters EFM. Symptoms, comorbidities, and health care in advanced chronic obstructive pulmonary disease or chronic heart failure. J Palliat Med. 2011;14(6):735–43.CrossRefPubMed Janssen DJA, Spruit MA, Uszko-Lencer NH, Schols JMGA, Wouters EFM. Symptoms, comorbidities, and health care in advanced chronic obstructive pulmonary disease or chronic heart failure. J Palliat Med. 2011;14(6):735–43.CrossRefPubMed
22.
go back to reference Radbruch L, Strasser F, Elsner F, Gonçalves JF, Løge J, Kaasa S, et al. Fatigue in palliative care patients—an EAPC approach. Palliat Med. 2008;22(1):13–32.CrossRefPubMed Radbruch L, Strasser F, Elsner F, Gonçalves JF, Løge J, Kaasa S, et al. Fatigue in palliative care patients—an EAPC approach. Palliat Med. 2008;22(1):13–32.CrossRefPubMed
23.
go back to reference Lamers RED, Cuypers M, Husson O, Vries M, Kil PJM, Ruud Bosch JLH, et al. Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psychooncology. 2016;25(6):633–40.CrossRefPubMed Lamers RED, Cuypers M, Husson O, Vries M, Kil PJM, Ruud Bosch JLH, et al. Patients are dissatisfied with information provision: perceived information provision and quality of life in prostate cancer patients. Psychooncology. 2016;25(6):633–40.CrossRefPubMed
24.
go back to reference Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2011;22(4):761–72.CrossRefPubMed Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2011;22(4):761–72.CrossRefPubMed
25.
go back to reference Halverson JL, Martinez-Donate AP, Palta M, Leal T, Lubner S, Walsh MC, et al. Health literacy and health-related quality of life among a population-based sample of cancer patients. J Health Commun. 2015;20(11):1320–9.CrossRefPubMedPubMedCentral Halverson JL, Martinez-Donate AP, Palta M, Leal T, Lubner S, Walsh MC, et al. Health literacy and health-related quality of life among a population-based sample of cancer patients. J Health Commun. 2015;20(11):1320–9.CrossRefPubMedPubMedCentral
26.
go back to reference Afrin LB, Self S, Menk J, Lazarchick J. Characterization of mast cell activation syndrome. Am J Med Sci. 2017;353(3):207–15.CrossRefPubMed Afrin LB, Self S, Menk J, Lazarchick J. Characterization of mast cell activation syndrome. Am J Med Sci. 2017;353(3):207–15.CrossRefPubMed
27.
go back to reference Molderings GJ, Haenisch B, Bogdanow M, Fimmers R, Nöthen MM. Familial occurrence of systemic mast cell activation disease. PLoS ONE. 2013;8(9):e76241.CrossRefPubMedPubMedCentral Molderings GJ, Haenisch B, Bogdanow M, Fimmers R, Nöthen MM. Familial occurrence of systemic mast cell activation disease. PLoS ONE. 2013;8(9):e76241.CrossRefPubMedPubMedCentral
29.
go back to reference Cohen SS, Skovbo S, Vestergaard H, Kristensen T, Møller M, Bindslev-Jensen C, et al. Epidemiology of systemic mastocytosis in Denmark. Br J Haematol. 2014;166(4):521–8.CrossRefPubMed Cohen SS, Skovbo S, Vestergaard H, Kristensen T, Møller M, Bindslev-Jensen C, et al. Epidemiology of systemic mastocytosis in Denmark. Br J Haematol. 2014;166(4):521–8.CrossRefPubMed
30.
go back to reference Lim K-H, Tefferi A, Lasho TL, Finke C, Patnaik M, Butterfield JH, et al. Systemic mastocytosis in 342 consecutive adults: survival studies and prognostic factors. Blood. 2009;113(23):5727–36.CrossRefPubMed Lim K-H, Tefferi A, Lasho TL, Finke C, Patnaik M, Butterfield JH, et al. Systemic mastocytosis in 342 consecutive adults: survival studies and prognostic factors. Blood. 2009;113(23):5727–36.CrossRefPubMed
32.
go back to reference Magliacane D, Parente R, Triggiani M. Current concepts on diagnosis and treatment of mastocytosis. Transl Med UniSa. 2014;8:65–74.PubMedPubMedCentral Magliacane D, Parente R, Triggiani M. Current concepts on diagnosis and treatment of mastocytosis. Transl Med UniSa. 2014;8:65–74.PubMedPubMedCentral
33.
go back to reference Weidema ME, Husson O, van der Graaf WTA, Leonard H, de Rooij BH, Hartle DeYoung L, et al. Health-related quality of life and symptom burden of epithelioid hemangioendothelioma patients: a global patient-driven Facebook study in a very rare malignancy. Acta Oncol. 2020;59(8):975–82.CrossRefPubMed Weidema ME, Husson O, van der Graaf WTA, Leonard H, de Rooij BH, Hartle DeYoung L, et al. Health-related quality of life and symptom burden of epithelioid hemangioendothelioma patients: a global patient-driven Facebook study in a very rare malignancy. Acta Oncol. 2020;59(8):975–82.CrossRefPubMed
34.
go back to reference Marinova M, Mücke M, Mahlberg L, Essler M, Cuhls H, Radbruch L, et al. Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30. Eur J Nucl Med Mol Imaging. 2018;45(1):38–46.CrossRefPubMed Marinova M, Mücke M, Mahlberg L, Essler M, Cuhls H, Radbruch L, et al. Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30. Eur J Nucl Med Mol Imaging. 2018;45(1):38–46.CrossRefPubMed
35.
go back to reference Teng FF, Kalloger SE, Brotto L, McAlpine JN. Determinants of quality of life in ovarian cancer survivors: a pilot study. J Obstet Gynaecol Can. 2014;36(8):708–15.CrossRefPubMed Teng FF, Kalloger SE, Brotto L, McAlpine JN. Determinants of quality of life in ovarian cancer survivors: a pilot study. J Obstet Gynaecol Can. 2014;36(8):708–15.CrossRefPubMed
36.
go back to reference Mochamat, Cuhls H, Sellin J, Conrad R, Radbruch L, Mücke M. Fatigue in advanced disease associated with palliative care: a systematic review of non-pharmacological treatments. Palliat Med. 2021;35(4):697–709.CrossRefPubMed Mochamat, Cuhls H, Sellin J, Conrad R, Radbruch L, Mücke M. Fatigue in advanced disease associated with palliative care: a systematic review of non-pharmacological treatments. Palliat Med. 2021;35(4):697–709.CrossRefPubMed
37.
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. JNCI J Natl Cancer Inst. 1993;85(5):365–76.CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. JNCI J Natl Cancer Inst. 1993;85(5):365–76.CrossRefPubMed
38.
go back to reference Arraras JI, Greimel E, Sezer O, Chie W-C, Bergenmar M, Costantini A, et al. An international validation study of the EORTC QLQ-INFO25 questionnaire: an instrument to assess the information given to cancer patients. Eur J Cancer. 2010;46(15):2726–38.CrossRefPubMed Arraras JI, Greimel E, Sezer O, Chie W-C, Bergenmar M, Costantini A, et al. An international validation study of the EORTC QLQ-INFO25 questionnaire: an instrument to assess the information given to cancer patients. Eur J Cancer. 2010;46(15):2726–38.CrossRefPubMed
Metadata
Title
Health-related quality of life and health literacy in patients with systemic mastocytosis and mast cell activation syndrome
Authors
Tobias Jürgen Schmidt
Julia Sellin
Gerhard J. Molderings
Rupert Conrad
Martin Mücke
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2022
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-022-02439-x

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