Cognitive symptoms in non-Hodgkin lymphoma survivors: Prevalence and discussion with doctors.

Abstract

9130 Background: Several studies have documented the negative impact of chemotherapy on patients’ cognitive functioning. However, this concern has been understudied among non-Hodgkin Lymphoma (NHL) survivors. Methods: We analyzed survey data from a population-based study of survivors diagnosed with aggressive NHL in Los Angeles County 2-5 years prior to the study; data were collected between 2003-2005. We assessed prevalence of cognitive symptoms (CS) by a single item screener that asked if in the past 6 months survivors experienced problems with memory, attention, or concentration; if yes, we asked if they discussed the problem with a doctor. Frequency of CS was assessed by a 4 item scale that measured how often survivors experienced different CS in the past 4 weeks (none, a little, some, most, all the time). Logistic regression analyses identified correlates of reporting CS (yes/no) as well as discussion with a doctor (yes/no). Analyses were based on data from 358 survivors who had received chemotherapy and saw a doctor for follow-up care in the past year. Results: 134/358 survivors (37%) reported CS, many reporting difficulty some, most, or all the time with memory (64%), attention (58%), concentration (57%), and problem solving (46%). Survivors with higher education, who were not married/partnered, and who had more comorbidities were more likely to report CS (p<0.05 for all). Report of CS was not associated with age, NHL grade, time since completion of chemotherapy, or having been treated with radiation or bone marrow/stem cell transplant. Of the 134 survivors who reported CS, only 43% discussed them with a doctor. Survivors who reported being given information about late effects of treatment were more likely to discuss CS than those who were not (OR: 3.4, 95% CI 1.4-8.5, p<0.01). Conclusions: One in three NHL survivors reported CS following chemotherapy; however, a majority did not discuss these with a doctor. Periodic screening for CS in NHL survivors may be needed and would provide an opportunity to improve patient-clinician communication about this issue. Additionally, research that identifies mechanisms that cause CS in this population is warranted in order to develop targeted behavioral and medical interventions.