Health-related quality of life in Hodgkin lymphoma: a systematic review

Abstract

PurposeHodgkin Lymphoma (HL) is highly curable with well-established treatment regimens; however, the impact on patient’s health-related quality of life (HRQL) from diagnosis through survivorship is unclear. This systematic review aimed to describe the available literature on HRQL in HL, assess the quality of these studies, identify gaps in the literature and recommend further areas of research.MethodsFollowing PRISMA guidelines, we performed a systematic review to include studies assessing the HRQL in HL patients. Articles identified through database searches were screened and data extracted. Quality was evaluated using a 6-point scale, adapted from published HRQL systematic reviews.ResultsSixty five articles published between 1986 and 2015 met inclusion criteria. These included 53 (82 %) cross-sectional studies; 12 (18 %) longitudinal studies, including three embedded in randomized trials; and three additional longitudinal studies that began assessment at diagnosis. Study sample sizes of HL patients varied considerably with only five (42 %) longitudinal studies including more than 50 patients. Multidimensional HRQL was assessed in 45 studies, single HRQL domains in 22 studies, and symptoms, including fatigue, in 28 studies.ConclusionsThe majority of studies employed a cross-sectional design, enrolling HL survivors at least 10 years after the completion of therapy. Emphasis on HRQL following therapy may inform initial treatment decisions and long-term survivorship goals. We recommend that future research include prospective, longitudinal randomized designs across both treatment and time.

Relapse Risk and Loss of Lifetime After Modern Combined Modality Treatment of Young Patients With Hodgkin Lymphoma: A Nordic Lymphoma Epidemiology Group Study

“…Furthermore, the reported analyses only describe the survival and relapse risk, since we have no information on detrimental effects of cHL on health-related quality of life, such as fatigue or sexual and psychosocial health. 48 A final caveat of this study is that the median follow-up of 9 years, although long compared with clinical trials, does not enable us to evaluate the very long-term effects of contemporary treatments.…”

Early‐stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long‐term patient outcomes

“…The six health states in our model (Fig 1) have utility weights ranging from zero ('dead' state) to as high as 0Á80 ('cured without relapse' state). Of note, little data inform preference-based health utilities for HL patients across these health states (Linendoll et al, 2016).…”

“…The six health states in our model (Fig ) have utility weights ranging from zero (‘dead’ state) to as high as 0·80 (‘cured without relapse’ state). Of note, little data inform preference‐based health utilities for HL patients across these health states (Linendoll et al , ). Our goal was to array utility weights in a plausible gradient from severe impairment to perfect health (see below).…”

Closing the survivorship gap in children and adolescents with Hodgkin lymphoma

“…Despite its debilitating impact on health, there is a paucity of data on cancer‐related fatigue, or longitudinal HRQoL among adult or paediatric HL patients during or following treatment (Linendoll et al , ). A longitudinal prospective evaluation of HRQoL in adults with HL enrolled on therapeutic trials noted severe levels of fatigue was common prior to the start of chemotherapy, and differed significantly by disease stage, whereas persistent fatigue in survivors did not correlate with level of therapy intensity (Kreissl et al , ).…”