The forgotten survivor: A comprehensive review on Non‐Hodgkin lymphoma survivorship

Abstract

The number of non-Hodgkin lymphoma (NHL) survivors is increasing. With the advancement of NHL therapies, it is crucial to focus on the challenges these survivors may face. Three main categories are to be considered in NHL survivorship, including quality of life and uncertainty about the future, possible physical health complications (including cardiovascular disease, infertility, and subsequent neoplasms), and the impact of novel NHL treatments and their potential complications. The latter includes CAR T-cell therapy, monoclonal antibodies, checkpoint inhibitors, and hematopoietic stem cell transplantation. In this report, we aim to shed the light on these aspects and to discuss survivorship care plan for NHL. | INTRODUCTIONIn the United States (US), more than 80 000 patients are diagnosed with non-Hodgkin lymphoma (NHL) annually, 1 and are considered survivors. 2 NHL comprises 4% of all malignancies; however, its impact on survivorship is disproportionate to its incidence due to the higher rates of survival compared with many more common cancers. The American Cancer Society (ACS) predicts that the incidence will rise as people in the U.S. continue to live longer and the risk of NHL increases with age. 1,3 Although this number is expected to proportionally grow with time as more patients are diagnosed and survive with NHL, cancer survivorship care in NHL survivors remains understudied (Figure 1).Cancer survivorship has become an essential part of the cancer care spectrum since formally described in 1986. 4 Many societies and committees are now available to help and guide survivors, their families, and physicians. For instance, the ACS currently has survivorship care guidelines for various solid tumors, including breast, prostate, colorectal, and head and neck cancers. 5 In the field of lymphoma, professional societies are actively developing such guidelines; however, a discrepancy in survivorship care between HL and NHL is observed, favoring HL, despite NHL being more prevalent. This is likely due to From the time of diagnosis onward, NHL patients face several challenges that can impact their physical, mental, and psychosocial wellbeing. 6 A population-based study 7 on 360 NHL patients 5-15 year after diagnosis (82% response rate) assessed their Health-Related Quality of Life (HRQoL) using the 36-item Short-Form Health Survey

Challenges for quality and utilization of real-world data for diffuse large B-cell lymphoma in REALYSA, a LYSA cohort

“… 12 , 13 In the field of lymphoma, RWD have, for instance, proven useful in developing clinical scores, defining new outcome end points, assessing the role of imaging in patient follow-up, and addressing long-term toxicities. 14 , 15 , 16 Interestingly, some prognostic scores and outcome end points were developed using RWD and subsequently validated on data from interventional trials. 17 , 18 , 19 , 20 , 21 RWD may come from various sources (eg, institution databases, administrative databases from health insurance, registries, cohorts, or directly from patients via connected electronic devices).…”

Review of Canine Lymphoma Treated with Chemotherapy—Outcomes and Prognostic Factors

“…Full classification of the lymphoma types in veterinary studies is often lacking, including in many recent studies that do not classify the disease beyond immunophenotype. This contrasts with studies of lymphoma in people where histological and genomic classifications are widely used as inclusion criteria in treatment studies [ 8 ]. People with lymphoma are routinely treated with immunotherapy with anti-CD20 monoclonal antibodies with high-risk B-cell lymphoma [ 8 ]; being able to clearly identify similar high-risk groups of dogs is required to justify the use of similar options.…”

“…This contrasts with studies of lymphoma in people where histological and genomic classifications are widely used as inclusion criteria in treatment studies [ 8 ]. People with lymphoma are routinely treated with immunotherapy with anti-CD20 monoclonal antibodies with high-risk B-cell lymphoma [ 8 ]; being able to clearly identify similar high-risk groups of dogs is required to justify the use of similar options. As veterinarians adopt some of these methods, better information will be important to enable the selection of suitable cases, as well as identifying the subtypes, both histological and molecular, that stand to benefit most from more, or less, aggressive interventions.…”