Health-related quality of life among survivors of aggressive non-Hodgkin lymphoma

Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC. .
Cancer (Impact Factor: 4.89). 02/2013; 119(3). DOI: 10.1002/cncr.27781
Source: PubMed


Non-Hodgkin lymphoma (NHL) is the fifth most common cancer among men and women. Patients with aggressive NHL receive intense medical treatments that can significantly compromise health-related quality of life (HRQOL). However, knowledge of HRQOL and its correlates among survivors of aggressive NHL is limited.

Self-reported data on HRQOL (physical and mental function, anxiety, depression, and fatigue) were analyzed for 319 survivors of aggressive NHL. Survivors 2 to 5 years postdiagnosis were selected from the Los Angeles County Cancer Registry. Bivariate and multivariable methods were used to assess the influence of sociodemographic, clinical, and cognitive health-appraisal factors on survivors' HRQOL.

After accounting for other covariates, marital status was associated with all HRQOL outcomes (P < .05). Younger survivors reported worse mental function and higher levels of depression, anxiety, and fatigue (P < .01). Survivors who had more comorbid conditions or lacked private health insurance reported worse physical and mental function and higher levels of depression and fatigue (P < .05). Survivors who experienced a recurrence reported worse physical function and higher levels of depression and fatigue (P < .05). With the exception of a nonsignificant association between perceived control and physical function, greater perceptions of personal control and health competence were associated significantly with more positive HRQOL outcomes (P < .01).

The current results indicated that survivors of aggressive NHL who are younger, are unmarried, lack private insurance, or experience greater illness burden may be at risk for poorer HRQOL. Cognitive health-appraisal factors were strongly related to HRQOL, suggesting potential benefits of interventions focused on these mutable factors for this population.

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    • "Cross-sectional studies and registry-based data analyses have documented that cancer survivors present with a variety of troubles that can lead to a decrease in their healthrelated quality of life (HRQoL). Compared to that of solid tumors (notably breast cancers), lymphoma survivorship has received little attention, but studies examining the course of morbidity in Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) survivorship have revealed that these patients experience psychological disorders (e.g., anxiety, depression, post-traumatic stress disorder [PTSD])123, delayed return to work [4], and a subsequent decrease in their HRQoL [3, 5]. Beside these complications, other severe concerns include the development of cardiovascular diseases and second malignancies, while relapse also remains possible, especially during the first 24-months post-therapy [6]. "
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