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Cancer. 2019 Mar 22. doi: 10.1002/cncr.32040. [Epub ahead of print]

Long-term fatigue in survivors of non-Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross-sectional study.

Author information

1
Onco-Hematology Unit, l'Archet Hospital, Nice University Hospital Center, University of Côte d'Azur, Nice, France.
2
Clinical Research and Innovation Office, Cimiez Hospital, Nice University Hospital Center, University of Côte d'Azur, Nice, France.
3
Mathematics, Information, and Engineering Systems (MIIS) Doctoral School, Caen-Normandy University, Caen, France.
4
French Center on eHealth, North-West Region Data Processing Center and French National League Against Cancer Clinical Research Platform, Caen, France.
5
Hemato-Oncology Unit, Saint-Louis University Hospital Center, Public Hospital Network of Paris, Paris, France.
6
Hematology Unit, Gustave Roussy Cancer Campus, Villejuif, France.
7
Hematology Department and French Institute of Health and Medical Research (INSERM) Unit 1243, Henri Becquerel Center, Rouen, France.
8
Lymphoid Malignancies Unit, Henri Mondor University Hospital Center, Public Hospital Network of Paris, Créteil, France.
9
Hematology Unit and French Institute of Health and Medical Research (INSERM) Unit 1231, Bocage Hospital, Dijon Bourgogne Regional University Hospital Center, Dijon, France.
10
Hematology Transfusion Institute, Claude Huriez Hospital, Lille Regional University Hospital Center, Lille, France.
11
Hematology Unit, Brabois Hospital, Nancy University Hospital Center, Vandœuvre-lès-Nancy, France.
12
Hematology Unit, Necker University Hospital for Sick Children, Public Hospital Network of Paris, Paris, France.
13
Oncopole, Toulouse University Cancer Institute, Toulouse, France.
14
Hematology Unit, Léon Bérard Center, Lyon, France.
15
Clinical Research Department-Lymphoma Study Association, Lyon South Hospital Center, Pierre-Bénite, France.
16
Basse-Normandy Hematology Institute, Côte de Nacre Regional University Hospital Center, Caen, France.
17
Regional Federative Institute of Cancerology, Besancon, France.
18
Laboratory of Biostatistics, Paris V University-Descartes, Paris, France.
19
Paoli-Calmettes Institute-Provence-Alpes-Côte d'Azur (IPC-PACA) Data Processing Center, Marseille, France.
20
Faculty of Medicine, Claude Bernard University, Lyon, France.
21
Hematology Department, Lyon South Hospital Center, Pierre-Bénite, France.

Abstract

BACKGROUND:

Long-term survivors of non-Hodgkin lymphoma (NHL) must cope with treatment complications and late toxicities that affect their health-related quality of life. Little is known about the risk-to-benefit ratio of new agents like rituximab. The impact of treatment regimens and health disorders on long-term fatigue levels was investigated in a cross-sectional study.

METHODS:

Two self-administered questionnaires, the 20-item Multidimensional Fatigue Inventory (MFI-20) and a Life Situation Questionnaire, were mailed in 2015 to NHL survivors enrolled onto 12 successive clinical studies (1993-2010) conducted by the Lymphoma Study Association. Private addresses were obtained for 3317 survivors, of whom 1671 (50%) returned the questionnaires. Severe fatigue was defined as MFI-20 scores ≥60 on dimension scales scored from 0 to 100. Linear regression models were used to assess factors that were linked to increased fatigue levels.

RESULTS:

The study population included 906 men and 765 women, and the median age was 64 years (age range, 24-95 years). Overall, 811 survivors had received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)-like chemotherapy, 518 had received high-dose CHOP, and 342 had undergone upfront autologous stem cell transplantation; 829 survivors also had received rituximab. In total, 1100 survivors (66%) reported 1 or more late health disorders. Severe fatigue was reported by 602 survivors (37%). Increased fatigue levels were associated (P < .001) with increased age, obesity, and the presence of health disorders, but not with initial treatment or rituximab.

CONCLUSIONS:

The survey confirms that high proportions long-term NHL survivors have severe fatigue. The results suggest that initial treatment and the receipt of rituximab have no influence on the development of long-term fatigue.

KEYWORDS:

cross-sectional study; long-term fatigue; long-term survivors; non-Hodgkin lymphomas; risk factors

PMID:
30901086
DOI:
10.1002/cncr.32040

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