PURPOSE Many important details of health-related quality of life (HRQoL) after diagnosis and treatment of Hodgkin lymphoma (HL) are still unknown because large longitudinal studies of HRQoL are rare. Therefore, we analyzed a systematically assessed, comprehensive range of HRQoL domains in patients with HL of all stages from diagnosis up to 5 years of survivorship. PATIENTS AND METHODS We included patients with HL age 18-60 years at diagnosis from the German Hodgkin Study Group trials HD13, HD14, and HD15. We analyzed HRQoL using all functional and symptom scales of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 including deviations from reference values. We estimated the effect of different disease, patient, and treatment characteristics using multiple regression and repeated measures analysis and computed correlations of HRQoL scores. RESULTS We analyzed 4,215 patients with any HRQoL assessment within 5 years after treatment. Higher tumor burden at diagnosis was associated with impaired baseline scores in many HRQoL domains. During survivorship, cognitive, emotional, role, and social functioning and fatigue, dyspnea, sleep, and financial problems were severely and persistently affected. From year 2 on, mean deviations from reference values ranged between 12 and 29 points, with 10 points being a commonly used margin of clinical relevance. In all 3 trials, HRQoL domains 2 and 5 years after therapy were significantly influenced by baseline scores and age but not by randomized treatments. Fatigue was most closely correlated with other symptoms and scales. CONCLUSION Our results show a high and persistent amount of different HRQoL deficits in survivors of HL that are largely independent of the applied chemotherapies. Our analysis underscores the high, unmet medical need of these rather young survivors of HL regarding the psychosocial adverse effects of the cancer experience.

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Material and Methods: 1,654 non-Hodgkin lymphoma (NHL) patients defined according to the modified Kiel classification and treated at the 3rd Medical Depart -ment/Hanusch Hospital between 1.1.1975 and 31.12.1989 were analysed with regard to clinical presentation and outcome. Results: The median follow-up in our collective was 112 months. Survival of patients with B-cell NHL differed significantly between the subgroups of patients with low-grade and those with high-grade malignancy (p = 0.001). No such difference was seen in patients with T-cell lymphomas (p = 0.7). Symptoms at presentation and outcome were evaluated, and significant differences between the entities were found. Aggressive therapy failed to improve prognosis in patients with low-grade NHL, whereas early aggressive chemotherapy was found to ameliorate the outcome of high-grade NHL (p = 0.008). Improvement in low-grade NHL (p = 0.02) comparing the same periods might be attributable to early diagnosis in CLL (chronic lymphocytic leukaemia) and better supportive care. Conclusions: Late relapse, development of secondary high-grade NHL (1.4% in CLL, 9% in IC: immunocytoma, 11% in CBCC: centroblastic centrocytic lymphoma, and 40% in AILD: angioimmunoblastic lymphoma) as well as development of secondary non-lymphatic neoplasia (12% in our collective) emphasize the necessity of long-term observation in NHL patients.