Quality of life in patients with diffuse large B-cell lymphoma treated with dose-dense chemotherapy is only affected temporarily

Abstract

(R)-CHOP-14 has substantially improved outcome in DLBCL, but may have increased morbidity and reduced quality of life (QoL). Our aim was to evaluate QoL during (R)-CHOP-14-based chemotherapy. Twenty-six patients participated (small single-center study). EORTC QLQ-C30 was completed pre-treatment, mid-treatment, 14 days post-treatment, and 3 months post-treatment. Scores were compared to a reference population, and analyzed separately. Pre-treatment, global health status (p = 0.004), physical functioning (p = 0.036), role functioning (p = 0.017), and emotional functioning (p = 0.040) were reduced, and fatigue (p = 0.009) and appetite loss (p = 0.007) increased compared to the reference population. During treatment, physical functioning and role functioning decreased significantly, whereas emotional functioning, fatigue, and diarrhea increased. Three months post-treatment, scores were generally equivalent to those of the reference population, and lower for nausea/vomiting (p < 0.001) and constipation (p < 0.001). Disease-related symptoms were frequent in high-risk DLBCL. Treatment-related symptoms were normalized 3 months post-treatment. In conclusion, QoL is only temporarily affected during (R)-CHOP-14-based chemotherapy, and the treatment regimen is therefore feasible.

Quality of life at diagnosis predicts overall survival in patients with aggressive lymphoma

“…We found that functional and physical WB were lower when measured in patients on active treatment as compared to patients prior to starting therapy, possibly due to chemotherapy side effects, while emotional WB and social/family WB scores were similar. While this is a cross-sectional comparison, a longitudinal study in patients with aggressive lymphoma reported a similar decline in physical function and role function QOL domains during the time of chemotherapy as compared to pre-treatment, with improvement to above baseline levels 3 months after completion of therapy [22].…”

“…The median overall raw FACT-G total score was 83 (range 70-93), and the median (range) scores on the functional WB, physical WB, emotional WB, and social/family WB were 18 (13-23), 22 (17-26), 18 (16)(17)(18)(19)(20)(21), and 25 (22)(23)(24)(25)(26)(27), respectively. Twenty-three percent had clinically significant overall QOL deficits on the LASA (score ≤ 50 on 0-100 scale).…”

Exploring the burden of short-term CHOP chemotherapy adverse events in post-transplant lymphoproliferative disease: a comprehensive literature review in lymphoma patients

“…The impact of CINV appeared to be transient with HRQoL returning to levels similar to the general reference population. The EORTC QLQ-C30 nausea/vomiting subscale score (a specific scale within the EORTC QLQ-C30 addressing the impact of nausea/vomiting on patient HRQoL) indicated that this event was the least burdensome of all symptoms assessed by this measure (fatigue, pain, and nausea/ vomiting); although scores do increase (worsen) during treatment, the overall humanistic impact remained low [47,48,50]. Data from other measures corroborated the low humanistic burden associated with CINV, especially when compared to other AEs of interest [27].…”

Quality of life research: adding an important dimension to the evaluation of therapeutic outcomes

“…However, concern has been raised about additional toxicities with this regimen [4,5]. The study reported in this issue of Leukemia & Lymphoma by Tholstrup et al on 'Quality of life in patients with diffuse large B-cell lymphoma treated with dosedense chemotherapy is only affected temporarily' [6] provides another dimension in evaluation of this therapy, finding that it has only short-term effects on quality of life, thus giving newly diagnosed patients a measure of hope and additional incentive to complete this regimen because it shows that their global health status, physical, and role functions will return to baseline levels within 3 months after completion of therapy.…”

“…Finally, the measure should be clinically meaningful such that differences between groups or over time can be interpreted as being clinically significant. Tholstrup et al [6] selected the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) including 30 questions, version 3 [11], abbreviated as the EORTC-QLQ30, which is one of the most widely used measures of overall quality of life in studies of patients with cancer on clinical trials. However, while other valid instruments exist, they may not be comparable, and thus it is necessary to compare studies using the same instrument [12].…”