Abstract
BackgroundPrevious studies have suggested that lymphoma survivors commonly display altered Health-Related Quality of Life (HRQoL). Because these were predominantly cross-sectional studies, the dynamic of events as well as the factors which influence HRQoL remain to be determined.MethodsWe conducted a prospective study on a cohort of 204 Hodgkin and non-Hodgkin lymphoma survivors who remained disease-free 2 years after undergoing chemotherapy (referred to the M0-M12-M24 periods).ResultsWe found that although Physical and Mental Component Scores (PCS and MCS) of HRQoL significantly improved from M0 to M24 in the vast majority of patients (favorable group), approximately 20% of patients displayed severe alterations in HRQoL (global SF-36 scores < 50) extending over the 2-year period (unfavorable group). Low M24 PCSs were associated with Post-Traumatic Stress Disorder (PTSD), depression, cardiovascular events and neuropathy. In contrast social determinants, comorbidity and infections, as well as several other parameters related to the disease or to the treatment itself were not associated with low M24 PCSs. Low M24 MCSs were associated with a low educational level, aggressive histology, infections, cardiovascular events and PTSS. However, the most predictive risk factor for low SF-36 scores at M24 was a low SF-36 score at M12. The unfavorable group also displayed a low incidence of return to work.ConclusionsAlthough the HRQoL of lymphoma survivors generally improved over time, persistent and severe HRQoL alterations still affected approximately one fifth of patients, resulting in important social consequences. This specific group, which presents with identifiable risk factors, may benefit from early, targeted psycho-social support.
Highlights
Previous studies have suggested that lymphoma survivors commonly display altered Health-Related Quality of Life (HRQoL)
The rate of relapse is below 10% for Hodgkin Lymphoma (HL) and ranges from 10 to 20% for most Non-Hodgkin Lymphomas (NHL), depending on risk factors and histological subtype, with the exception of more aggressive forms such as T-cell derived NHL (10% of cases) [4]
The current study aims to assess the proportion of patients with a significantly reduced quality of life after 2 years of post-cancer follow-up and to identify associated risk factors with a specific focus on physical events as well as psychological disturbances occurring during this time period
Summary
Previous studies have suggested that lymphoma survivors commonly display altered Health-Related Quality of Life (HRQoL). Because these were predominantly cross-sectional studies, the dynamic of events as well as the factors which influence HRQoL remain to be determined. Both Non-Hodgkin and Hodgkin Lymphomas (NHL and HL, respectively) are both considered to be very chemosensitive cancers. For NHL, the standard RCHOP21 or RCHOP14 regimens approximately yield an 80% response rate, with the majority of cases achieving a complete response (CR) [2]. Therapy is potentially associated with acute toxicities such as sepsis, mucitis, fatigue and cytopenias, which sometimes require transfusions, chemotherapy toxicity remains generally acceptable as reflected by the high rate of dose adherence [5]
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