Late Effects of Treatment Linked with QOL in Long-Term Lymphoma Survivors

Long-term survivors of lymphoma who underwent high-dose therapy autologous hematopoietic cell transplantation (AHCT) had impaired health-related quality of life (HRQOL), according to a recent study. Impaired HRQOL seems to be driven by late effects of treatment.

Researchers assessed total late effect burden among 271 survivors of lymphoma who had undergone high-dose therapy AHCT from 1987 and 2008. All patients had a comprehensive clinical assessment and completed a questionnaire. The median age at survey completion was 56 years.

At a median of 8 years after high-dose therapy AHCT, 98% of survivors had at least one moderate or more severe late effect of therapy, and 56% had severe or life-threatening late effects. The endocrine system was the most commonly affected organ system (94%), followed by the cardiovascular system (86%).

The researchers identified several factors associated with having high late effect burden, including female sex, increasing age, B-symptoms at diagnosis, and more than one treatment line prior to transplant.

Compared with age and sex-matched controls, lymphoma survivors who had undergone high-dose therapy AHCT had significantly worse physical and mental HRQOL. Poor physical and mental HRQOL increased with higher late effect burden (P<.001 for both). In contrast, the low late effect burden group had improved physical HRQOL (P<.001).

“This highlights the importance of efforts to prevent and treat any late effect or chronic conditions of somatic or psychosocial character experienced by heavily treated cancer survivors,” the researchers wrote. “This could include risk-stratified survivorship surveillance and survivorship care that includes focus on lifestyle and health-related behavior and enables early detection and management of conditions amendable to interventions.”

Smeland K, Holte H, Fagerli U-M, et al. Total late effect burden in long-term lymphoma survivors after high-dose therapy with autologous stem-cell transplant and its effect on health-related quality of life. Haematologica. 2022. doi:10.3324/haematol.2021.280413