Abstract
BackgroundDue to risk and response adapted treatment strategies, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured, and become long-term survivors. However, a high proportion of survivors suffer from treatment-related long-term side effects such as secondary malignancy, organ failure, persistent fatigue and psychological distress. The aim of this study was to evaluate psychological distress and its risk factors among our HL survivors.MethodsOne hundred sixty-three (50% female) adult HL survivors were contacted between January 1, 2012 and march 31, 2015 in our outpatient centre. The patients were asked to complete a standardized, validated, self-administered Hungarian questionnaire with demographic questions and the following scales: Hospital anxiety and depression scale (HADS14), general health questionnaire (GHQ12), sense of coherence (SOC13) perceived stress scale (PSS4), dysfunctional attitude scale (DAS17). Disease and treatment data were acquired from hospital records.ResultsMajority of HL survivors are in early adulthood, our most important goal should be to return them to normal life after their lymphoma is cured. The employment status at the time of survey seemed to be crucial so patients were divided into either active (n = 93) or inactive (n = 47) group. Retired survivors (n = 19) were excluded from the subgroup analysis. Psychological distress was significantly lower in active patients. Multiple logistic regression analysis showed significant differences between the inactive and active subgroups, such as age at diagnosis (≥30 years or below, p = 0.001), education level (below college vs. college, p = 0.032) and treatment related long-term side effects (yes vs. no, p < 0.001). Predictors for treatment-related long-term side effects are female gender (p = 0.011), chemotherapy protocol (ABVD vs. other, p < 0.001).ConclusionsOur data suggest that employment status and treatment-related long-term side effects play a critical role in the health related quality of life outcome among Hungarian HL survivors.
Highlights
Patient characteristics A total of 163 adult Hodgkin lymphoma (HL) survivors completed the survey. 19 persons were beyond retirement age of 65 years and 4 persons had unknown employment status who were excluded from the subgroup analysis
Employment status The majority of HL survivors had been in early adulthood at the time of diagnosis
Employment at the time of the survey was defined as crucial factor of normal life so the survivors were split into two subgroups based on employment status: active (93 patients) and inactive (47 patients, see Fig. 1)
Summary
Due to risk and response adapted treatment strategies, more than 80% of newly diagnosed classical Hodgkin lymphoma (HL) patients can be cured, and become long-term survivors. A high proportion of survivors suffer from treatment-related long-term side effects such as secondary malignancy, organ failure, persistent fatigue and psychological distress. Due to risk and response adapted treatment strategies, more than 80% of newly diagnosed Hodgkin lymphoma (HL) patients at any stage can be cured, and are expected to be long-term survivors [1,2,3]. Treatment related long-term side effects such as secondary malignancy, or organ failure reduces the quality of life and life expectancy of survivors. The purpose of our study was to evaluate the frequency of psychological distress and its risk factors among HL survivors based on our single centre experience
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