OBJECTIVES: 1) To characterize the impact of multiple myeloma on the quality of life of patients treated in two public institutions in São 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.

OBJETIVO: Avaliar a precisão das doses de radiação absorvidas na terapia de transplantes de medula óssea durante a técnica de irradiação de corpo inteiro. MATERIAIS E MÉTODOS: Utilizaram-se 200 pastilhas de sulfato de cálcio com disprósio compactado com teflon (CaSO4 + teflon), calibradas no ar e no "phantom", selecionadas aleatoriamente e dispostas em grupos de cinco no corpo dos pacientes. As leituras dosimétricas foram efetuadas pela leitora Harshaw 4000A. Nove pacientes foram irradiados no corpo inteiro em paralelos e em opostos laterais, utilizando-se unidade de cobalto-60, modelo Alcion II, com taxa de dose de 0,80 Gy/min a 80,5 cm, {campo (10 × 10) cm²}. A dosimetria dessa unidade foi realizada com dosímetro Victoreen 500. Para a determinação da dose média em cada ponto avaliado usaram-se os fatores individuais de calibração das pastilhas no ar e no "phantom", colocando-se um "build up" de 2 mm para superficializar a dose à distância de 300 cm. RESULTADOS: Em 70% dos pacientes obteve-se variação de dose menor que 5% e em 30% dos pacientes essa variação foi inferior a 10%, quando comparados os valores medidos com aqueles calculados em cada ponto. Na cabeça ocorre absorção, em média, de 14% da dose administrada, e nos pulmões, acréscimo de 2% na dose administrada. Nos pacientes com distância látero-lateral maior que 35 cm as variações entre as doses calculadas e medidas podem chegar a 30% da dose desejada, sem o uso de filtros compensadores. CONCLUSÃO: Os valores medidos das doses absorvidas nos diversos pontos anatômicos, comparados aos valores desejados (teóricos), apresentam tolerância de ±10%, considerando-se as diferenças anatômicas existentes, quando utilizados os fatores de calibração individuais das pastilhas.

OBJECTIVE: To evaluate the precision of the absorbed radiation doses in bone marrow transplant therapy during whole body irradiation. MATERIALS AND METHODS: Two-hundred CaSO4:Dy + teflon tablets were calibrated in air and in "phantom". These tablets were randomly selected and divided in groups of five in the patients' body. The dosimetric readings were obtained using a Harshaw 4000A reader. Nine patients had their entire bodies irradiated in parallel and opposite laterals in a cobalt-60 Alcion II model, with a dose rate of 0.80 Gy/min at 80.5 cm, {(10 × 10) cm² field}. The dosimetry of this unit was performed using a Victoreen 500 dosimeter. For the determination of the mean dose at each point evaluated, the individual values of the tablets calibrated in air or "phantom" were used, resulting in a build up of 2 mm to superficialize the dose at a distance of 300 cm. RESULTS: In 70% of the patients a variation of less than 5% in the dose was obtained. In 30% of the patients this variation was less than 10%, when values obtained were compared to the values calculated at each point. A mean absorption of 14% was seen in the head, and an increase of 2% of the administered dose was seen in the lungs. In patients with latero-lateral distance greater than 35 cm the variation between the calculated doses and the measured doses reached 30% of the desired dose, without the use of compensation filters. CONCLUSION: The measured values of the absorbed doses at the various anatomic points compared to the desired doses (theoretic) presented a tolerance of ± 10%, considering the existent anatomical differences and when using the individual calibration factors of the tablets.